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Studies  in 

Abnormal  Psychology 

Q \Y\  \ 

\ 'A  ' ‘ 


SERIES  VIII 


RICHARD  G.  BADGER 

THE  GORHAM  PRESS 
BOSTON 


Copyright  1917,  1918,  by  Richard  G.  Badger 
All  Rights  Reserved 


In  view  of  the  great  importance  of  the  contributions  of 
eminent  specialists  in  psychology  which  have  been  published 
in  The  Journal  of  Abnormal  Psychology  and  the  in- 
creasing demand  for  the  same,  the  publisher  has  been  en- 
couraged to  re-issue  such  numbers  as  are  in  print,  in  order 
that  this  valuable  material  may  be  more  accessible  to  the 
general  reader.  The  first  series  contains  the  articles  pub- 
lished in  the  issues  of  the  magazine  from  April,  1910  to  March 
1911,  inclusive;  the  second  series  those  published  from  April, 
1911,  to  March,  1912,  inclusive;  the  third  series  those 
published  from  April,  1912,  to  Alarch,  1913,  inclusive*;  the 
fourth  series  from  April,  1913,  to  March,  1914,  inclusive;  the 
fifth  series  from  April,  1914,  to  March,  1915,  inclusive;  the 
sixth  series  from  April,  1915,  to  March,  1916,  inclusive;  the 
seventh  series  from  April,  1916,  to  Alarch,  1917,  inclusive, 
and  the  eighth  series  from  April,  1917,  to  Alarch,  1918, 
inclusive. 

Many  of  the  earlier  numbers  of  the  magazine  are  already 
out  of  print,  so  that  no  collected  volumes  can  easily  be  made 
to  cover  their  contents;  some  of  these  numbers  have,  how- 
ever, been  gathered  together  under  the  title  of  Abnormal 
Psychology;  Interpretations  and  Investigations. 

*Out  of  print. 


VO 


INDEX  TO  SUBJECTS 

(Figures  with  asterisks  indicate  original  articles.  Figures  without  asterisks  indicate 
abstracts,  reviews,  society  reports,  correspondence  and  discussions.) 

PACE 

Adler;  The  Adlerian  Concept  of  the  Neuroses  (White) *168 

Adler;  Notes  with  Reference  to  (Burrow) *161 

Affective  Physiology,  Notes  on.  (Dearborn) 353 

Anesthesia.  (Kempf) *1 

Animal  Behaviour,  Studies  in  (Holmes) 70 

Analyses  in  the  Psychopathology  of  Everyday  Life  (Frink) *25 

Aphonia  (Sidis) *100 

Catalepsy  (Sidis) . . 7*. *100 

Character,  Sketch  for  a Study  of  New  England  (Putnam) *73 

Children,  Mentally  Defective  (Binet  & Simon) 278 

Children,  Nervous  (Tucker) . 358 

Circulation,  The,  and  Sleep  (Shepard) 432 

Clinical  Psychologists.  Report  of  Committee  of  New  York  Psychiatrical  Society  on 

the  Activities  of 142 

Coconscious  Images  (Prince) *289 

Conduct  of  the  Insane  (Gosline) *240 

Conflict,  Man’s  Unconscious  (Lay) 284 

Conflicts,  and  Misconduct,  Mental  (Healy) 211 

Convulsions  (Kempf) *1 

Defective  Children,  Mentally  (Binet  & Simon) 278 

Dementia  Praecox,  Treatment  of  by  Analysis  (Coriat) *329 

Emotions  in  the  Genesis  of  Insanity,  Role  of  (Wechsler) *375 

Erythema  (Kempf) *1 

Eupathics.  (Myerson) *343 

Freud,  Notes  with  Reference  to  (Burrow) *49 

Freud,  Some  Criticisms  of  the  Freudian  Psychology  (Woodworth) *174 

Freud,  The  Work  of  Sigmund  Freud  (Putnam) *161 

Genius,  Philistine  and  (Sidis) 285 

Hallucinations,  Obsessive  . . . and  Psychoanalysis  (Gordon) *423 

Home,  The  Deforming  Influence  of  the  (Brown) *49 

Hunger,  The  Control  of — in  Health  and  Disease  (Carleson) 433 

Ideas,  How  Far  Can  Ideas  Directly  Influence  or  Affect  Peripheral  Processes.  (Solomon)  *331 

Influence,  Deforming — of  the  Home  (Brown) *49 

Insane,  The  Conduct  of  the  (Gosline) *240 

Insanity  in  American  Prisons  (Brock) *232 

Insanity;  Role  of  the  Emotions  in  the  Genesis  of — and  Insanity  from  the  Standpoint  of 

Evolution.  (Wechsler).' *375 

Intelligence,  Psychological  Method  of  Testing  (Stem) 69 

Itching  (Kempf) *1 

Joy,  The  Influence  of  (Dearborn) 70 

Jung,  Notes  with  Reference  to  (Burrow) *161 

Leonardo  da  Vinci  (Freud) 140 

Mechanistic  View  of  War  and  Peace  (Crile) 431 

Mental  Conflicts  and  Misconduct  (Healy) 211 

Mental  Diseases  (Patrick  & Bassoe) * 140 

Mental  Torticollis.,  A Discussion  of  the  Mechanism  of  (Clark) *257 

Nervous  Diseases  (Patrick  & Bassoe) 140 

Neuroses,  The  Adlerian  Concept  of  (White) *168 

Neurotic  Constitution,  The  (Adler) 206 

Organ  Inferiority,  A Study  of  and  Its  Psychical  Compensation,  (Adler) 348 

Pain,  The  Relief  of  By  Mental  Suggestion  (Batten) 357 

Peripheral  Processes,  How  Far  Can  Ideas  Directly  Influence  or  Affect  the  (Solomon). . *331 

Personality,  Suggestions  for  a Scheme  of  Graphic  Representations  of(  Singer) *114 

Philistine  and  Genius  (Sidis) 285 

Physiology,  Notes  on  Affective  (Dearborn) 353 

Pestalozzi,  Life  and  Works  of  (Green) 69 

Proceedings  of  the  American  Society  for  Psychical  Research 280 

Psychiatry,  Manual  of  (De  Fursac  & Rosanoff) 278 

Psychiatry,  Studies  in  Forensic  (Glueck) 354 

Psychoanalysis,  History  of  (Bjerre) 351 

Psychoanalysis,  Meaning  of  (Burrow)  (Myerson) *200  *58 

Psychoanalysis,  Some  Current  Misconceptions  of  (Tannenbaum) *390 

Psychoanalysis,  Suggestions  Regarding  a Modified  (Taylor) *361 

Psychoanalytic  Method,  A Further  Application  of  the  (Gosline) *317 

Psychoanalysis,  Obsessive  Hallucinations  and  (Gordon) *423 

Psychoanalysis,  Treatment  of  Dementia  Praecox  by  (Coriat) *326 

Psychoanalysis,  What  is  (Coriat) 141 

161964 


INDEX  TO  SUBJECTS 


Psychological  Clinic  of  Southern  California,  Association  of  Applied  Science  (Owen).  . . *217 

Psychological  Methods  of  Testing  Intelligence  (Stern) 69 

Psychological  Test  Measurements — Distinctive  Features  in  Made  Upon  Dementia 

Praecox  and  Chronic  Alcoholic  Patients,  (Pressey) *130 

Psychology,  A Beginner’s  (Titchener) 359 

Psychology,  Criticisms  of  the  Freudian  (Woodworth) *174 

Psychology  of  Special  Abilities  and  Disabilities  (Bronner) 282 

Psychopathic  Aphonia,  Stammering  and  Catalepsy  (Sidis) *100 

Psychopathology  of  Everyday  Life,  Some  Analyses  of  (Frink) *25 

Psychopathology,  Need  for  a Stricter  Definition  of  Terms  in  (Solomon) *195 

Psychoses,  Insanity  in  American  Prisons  and  the  Prison  (Brock) *232 

Psychosis,  Suggestions  for  a Scheme  of  Graphic  Representation  of  Personality  and 

(Singer) *114 

Sleep,  The  Circulation  and  (Shepard) 432 

Stammering  (Sidis) *100 

Stammering  Discussions  (Tompkins) *260 

Studies  in  Animal  Behaviour  (Holmes) 74 

Studies  in  Forensic  Psychiatry  (Glueck) 350 

Study,  Sketch  for  a ...  of  New  England  Character  (Putnam) *73 

Study  of  Organ  Inferiority  and  Its  Psychical  Compensation  (Adler) 348 

Stuttering  Boy,  The  (Dunlap) *44 

Stutterers,  The  Mental  Imagery  of  An  Examination  of  Certain  Current  Theories 

(Fletcher) *34 

Unconscious,  Wit  and  Its  Relation  to  The  (Freud) • 215 

Visual  Constriction  (Kempf) *1 

Vomiting  (Kempf) *1 

Wit  and  Its  Relation  to  the  Unconscious  (Freud) 215 


CONTRIBUTORS  TO  SERIES  VIII 


Abbot,  E.  Stanley 280 

Brock,  G.  W 232 

Brown,  Helen  Williston 49 

Burrow,  Trigant 58-161 

Clark,  L.  Pierce „ 257 

Coriat,  I.  H 357 

Dearborn,  G.  V.  N 432 

Dearborn,  W.  F 278 

Dunlap,  Knight ' 44 

Fletcher,  John  W 34 

Frink,  H.  W 25 

Gesell,  Arnold  L 69 

Gibler,  R.  C. 431 

Gordon,  Alfred 423 

Gosline,  Harold  1 240,  317 

Kempf,  Edward  J 1 

Kubie,  Lawrence  S 358 

Langfield,  Herbert  S 433 

Moore,  Jared  S 356 

Myerson,  Abraham 200,  343 

Owen,  F.  E 217 

Prince,  Morton 289 

Pressey,  S.  L 130 

Putnam,  J.  J * . . *. 73-145 

Reed,  Ralph 359 

Sidis,  Boris 100 

Singer,  H.  Douglas 114 

Solomon,  Meyer 70-140-141-195-206-211-215-280-282-284-286-331-348-351-353-354 

Tannenbaum,  S.  A 390 

Taylor,  E.  W 361 

Tompkins,  Ernest 260 

Wechsler,  I.  S 375 

White,  William  A 16S 

Woodworth,  R.  S 174 

Yerkes,  Robert  M 72 


THE  JOURNAL  OF 
ABNORMAL  PSYCHOLOGY 


A STUDY  OF  THE  ANAESTHESIA,  CONVULSIONS, 
VOMITING,  VISUAL  CONSTRICTION, 
ERYTHEMA  AND  ITCHING  OF  MRS. 

V.  G. 

BY  EDWARD  J.  KEMPF,  M.  D. 

Clinical  Psychiatrist  to  Saint  Elizabeth' s Hospital, 
Washington , D.  C. 

IN  July  of  1912  a slender,  dark  complexioned  girlish  look- 
ing woman  of  medium  height,  21  years  old,  was  admitted 
to  a State  Hospital  for  the  insane  because  she  could  not 
control  her  “hatrish  feelings”  and  “jerking  spells.” 
During  the  admission  procedures  she  sat  quietly  in  an  incon- 
spicuous chair.  Her  head  was  lowered  so  that  the  brim  of 
her  hat  concealed  most  of  her  features  and  when  she  did 
look  up  the  brim  of  the  hat  was  timidly  lifted  just  high 
enough  to  allow-  her  eyes  to  peer  beneath  the  edge.  She 
smiled  at  almost  every  remark  addressed  to  her.  This  con- 
trasted strangely  with  the  uncontrollable  feelings  of  hatred 
that  she  complained  of,  and  indicated  compensatory  efforts 
to  hide  these  feelings.  Her  husband  gave  the  usual  brief 
account  of  her  illness,  but  carefully  hid  his  feelings  of  personal 
responsibility  and  any  intimation  of  insight  into  her  con- 
dition. However,  he  was  very  solicitous  of  her  welfare. 

Her  life  on  the  ward  for  the  first  few  days  was  unevent- 
ful. She  adjusted  herself  fairly  well  to  her  companions  and 
the  routine  requirements  and  found  some  light  work  for 
herself  to  shorten  the  periods  of  idleness. 

When  her  ear  was  pricked  in  order  to  take  a blood 
specimen  she  submitted  to  the  procedure  without  any  signs 
of  uneasiness  until  after  the  operation  was  practically 


1 


I 


2 A Study  of  the  Anaesthesia , Etc .,  of  Mrs.  F.  G. 

finished.  Then  suddenly  she  became  embarrassed  and 
seemed  to  be  very  uncomfortable  but  said  nothing  to  the 
physician. 

One  morning  after  this  incident  when  I made  my  ward 
rounds  I found  her  standing  before  a window,  very  much 
embarrassed.  Her  body  muscles  were  jerking  vigorously 
and  she  explained  when  I approached  that  she  hated  “that 
man  more  than  any  one  in  the  world.”  She  referred  to  the 
physician  that  made  the  ear  puncture,  whom  she  had  just 
seen  pass  by  the  building.  She  could  not  explain  why  she 
hated  him.  He  had  not  hurt  her  and  had  been  kind  and 
careful  she  said,  but  nevertheless  when  she  saw  him  she  felt 
an  intense  hatred  for  him. 

Within  a few  days  after  her  admission  the  “jerking 
spells”  or  “hatrish  feelings”  recurred  so  frequently  that  she 
was  seldom  without  them.  She  complained  pitifully  that, 
despite  her  efforts  to  control  herself,  even  the  slightest  com- 
mands of  the  nurses  affected  her. 

Such  impersonal  orders  as  the  call  of  the  patients  to 
attend  dinner  caused  her  to  feel  intensely  embarrassed  and 
resistant  even  though,  as  she  expressed  herself,  she  knew 
better.  She  told  me  of  one  of  her  reactions  when  she  was 
in  the  grove  with  her  ward.  “She  (the  nurse)  called  us  in  a 
very  pleasant  voice  (to  come  to  the  ward)  but  it  affected  me 
so  deeply  that  in  a second  my  thoughts  wfere  in  a whirl.  I 
came  in  and  went  to  my  room  and  cried.  All  those  bitter 
thoughts  back  to  my  childhood  rushed  through  my  mind. 
I could  see  them  all  like  a flash  pass  in  a string  and  it  made 
me  feel  so  bitter  I cried  and  then  went  to  sleep.  But  today 
I feel  better.” 

It  was  observed  that  practically  all  of  the  muscles  of 
her  body  “jerked,”  that  is,  became  involved  in  convulsions 
during  many  of  these  episodes.  The  jerks  of  the  recti 
abdominis  were  included  in  the  large  group  of  muscles  which 
were  involved,  and  not  until  later  was  it  ascertained  that 
this  activity  was  conditioned  by  a distinct  experience. 
With  the  attacks  she  would  often  beat  herself  and  dig  her 
nails  into  the  palms.  She  was  afraid  that  she  might  injure 
herself  or  someone.  She  did  not  hallucinate  nor  lose  con- 


sciousness. 


Edward  J.  Kempf 


3 


Upon  examination  without  a perimeter  it  was  found 
that  her  visual  field  for  colors  was  markedly  constricted  for 
the  right  eye  and  practically  normal  for  the  left  eye. 

The  patient  did  not  react  to  heat,  cold,  touch  or  pain, 
except  sometimes  when  it  was  strongly  suggested  that  she 
could  feel  the  stimulus,  over  the  right  side  of  the  face  and 
neck,  right  shoulder,  arm,  trunk  and  leg.  To  stimuli  over 
the  posterior  surfaces  below  the  waist  she  also  gave  practical- 
ly no  response.  The  left  side  varied  considerably  at  differ- 
ent times  but  on  the  whole  the  sensations  were  normal  over 
the  left  half  of  the  face,  shoulder  and  arm,  except  the  hand 
and  a narrow  strip  which  ran  down  the  left  side  of  the  body 
and  leg  to  the  ankle.  Stimulation  of  the  hands  and  feet 
yielded  no  response.  She  had  never  complained  of  loss  of 
sensation,  had  no  idea  of  its  duration,  and  seemed  to  be 
surprised  at  the  discovery. 

On  the  extensor  surfaces  of  each  forearm,  about  midway 
between  the  elbow  and  wrist,  was  an  irregular,  blotchy,  slightly 
raised  erythematous  surface.  Each  area  was  about  as  large 
as  the  finger  surface  of  a woman’s  hand.  These  areas  itched 
considerably  at  times  and  she  insisted  that  it  was  a skin 
disease  which  she  had  had  for  more  than  a year  and  did  not 
worry  about,  and  which  had  nothing  to  do  with  her  illness. 
Her  subjective  complaints  consisted  of  “hatrish  feelings,” 
“ jerking  spells”  and  nausea  caused  by  red  fruits  and  vege- 
tables. This  nausea  became  so  intense  that  she  vomited 
when  she  ate  red  fruits  or  vegetables. 

To  sum  up  her  symptoms  she  had  (i)  uncontrollable 
periods  of  intense  hatred  and  jealousy  for  principally  her 
husband,  mother-in-law  and  her  grandmother;  (2)  periods 
of  jerking  of  practically  all  her  voluntary  muscles,  and  (3) 
an  independent  jerking  of  her  abdominal  muscles;  (4)  normal 
sensation  for  her  left  face,  chest,  arm,  side  of  body  and  leg 
and  back  above  the  waist,  with  hypaesthesia  to  anaesthesia 
for  the  rest  of  her  body;  (5)  an  area  of  independent  anaesthes- 
ia for  the  right  upper  face;  (6)  constriction  of  the  field  for 
color  vision  in  the  right  eye,  particularly  red;  (7)  nausea  and 
vomiting  caused  by  red  fruits  and  vegetables;  (8)  erythema- 
tous blotches  on  the  extensor  surface  of  each  forearm  and 
(9)  periods  of  intense  itching  over  these  surfaces. 


4 


A Study  of  the  Anaesthesia , Etc.,  of  Mrs.  V.  G. 


The  patient’s  family  history  was  negative.  Her  parents 
died  when  she  was  two  years  old.  She  was  adopted  by  a 
neighbor  woman  whom  she  was  very  fond  of  and  always 
regarded  as  her  mother.  This  woman  taught  her  the  Catho- 
lic faith,  gave  her  a comfortable  home,  and  provided  for 
the  usual  childhood  education.  She  was  probably  an  ex- 
cessively petted  child.  She  was  taught  by  her  foster  mother 
to  fear  and  avoid  a certain  “mean”  old  lady.  Unfortunately 
this  old  lady,  who  was  her  grandmother,  caught  her  on  the 
street  when  she  was  about  ten  years  old  and  kidnapped  her, 
despite  her  cries  and  protests.  From  that  day  on  she  lived 
very  unhappily  with  this  grandmother.  The  patient  always 
believed  that  the  shock  of  the  kidnapping,  her  great  fear 
and  her  hatred  of  her  grandmother,  reenforced  by  the  long 
years  of  unhappiness,  caused  her  to  become  abnormal. 

As  a child  of  her  foster  mother  she  had  been  petted, 
spoiled  and  given  every  comfort  and  attention.  After  she 
was  kidnapped  she  was  always  miserable,  scolded,  whipped, 
lonely  and  unhappy.  She  had  to  sleep  alone  upstairs  and 
frequently,  because  of  fear,  she  sneaked  to  the  head  of  the 
stairs  and  there  cried  herself  to  sleep.  She  was  often  pun- 
ished for  this  but  the  punishment  did  not  stop  the  fear. 
After  her  grandfather  died  her  night  terrors  left  her. 

Other  than  this  constant  exposure  to  the  unintelligent 
domination  by  a much  older,  unsympathetic  personality  her 
life  was  uneventful  until  the  period  of  her  engagement  and 
marriage. 

The  grandmother  was  an  earnest  Catholic,  but  the 
patient,  as  she  said,  felt  very  little  interest  in  that  faith. 
The  persistent  old  lady  had  no  patience  for  such  girlish 
irresponsibility  and  planned  out  her  course  in  life  without- 
considering  the  wishes  of  the  young  woman.  She  selected  a 
young  Catholic  man  to  be  her  granddaughter’s  husband, 
and  at  what  seemed  to  be  the  propitious  time  announced  her 
engagement  to  him  in  the  newspapers.  But  this  selection, 
like  most  of  her  grandmother’s  ideas,  was  quite  different 
from  that  which  the  young  woman  desired.  This  young 
man,  she  said,  was  a flirt  and  was  known  in  the  neighbor- 
hood as  an  immoral  man.  For  some  reason  that  she  did  not 
quite  understand  she  liked  him  and  often  fancied  herself 


Edward  J.  Kempf 


5 


the  object  of  his  flirtations,  but  she  was  never  able  to  trust 
him  or  to  love  him.  She  was  in  love,  she  thought,  with  a 
young  Protestant  and  despite  her  religion  and  her  grand- 
mother’s horror  she  determined  to  marry  him.  The  grand- 
mother did  not  know  of  their  engagement  but  suspected  it 
and  determined  to  forestall  the  proposition  by  announcing 
the  engagement  in  the  papers. 

The  newspaper  episode  precipitated  a crisis.  The  next 
day  the  patient  denied  the  engagement  in  the  papers.  A 
furious  debate  between  the  two  women  resulted.  The 
grandmother  would  not  permit  her  fiance  to  see  her  but 
kept  her  in  the  house  and  sent  for  the  parish  priest.  The 
two  people  tried  to  convince  the  girl  that  she  would  make  a 
mistake  if  she  should  marry  the  Protestant.  In  the  after- 
noon the  patient  was  locked  in  her  bedroom  by  the  grand- 
mother and  informed  that  she  would  be  kept  there  until  she 
promised  to  marry  the  Catholic.  (The  remaining  details 
of  the  scene  which  developed  while  she  was  in  the  room  were 
forgotten  by  the  patient  and  will  be  described  later  as  part 
of  the  psychoanalysis.) 

Later  in  the  afternoon  the  patient  managed  to  escape 
from  the  house  and  stayed  with  her  future  sister-in-law. 
A few  days  later  she  married  the  Protestant. 

(It  may  be  best  to  note  here  that  this  sister-in-law  had 
been  subject  to  violent  “jerking  spells”  since  the  birth  of 
her  first  baby.  The  muscles  involved  were  principally  the 
abdominal,  according  to  our  patient’s  statement.) 

She  married  in  March  at  the  age  of  19.  Soon  after  this 
her  psychoneurosis  became  apparent  and  it  developed 
rapidly.  A sequence  of  unhappy  experiences  in  an  environ- 
ment that  was  peculiarly  suited  to  expose  her  to  a series  of 
most  unpleasant  conflicts,  soon  proved  too  much  for  the 
patient. 

Her  husband’s  parents  lived  alone  on  a farm  which 
they  had  occupied  for  years.  The  young  couple  were  to 
take  complete  charge  of  all  its  details  and  live  with  the  old 
people.  This  proved  unfortunate  because  the  mother-in- 
law  could  not  give  up  her  dictatorship  of  a household  that 
she  had  dominated  for  years.  The  young  wife  was  in  per- 
petual conflict  with  her.  She  was  in  reality  exposed  again 


6 A Study  of  the  Anaesthesia , Etc.,  of  Mrs.  V.  G. 

to  her  perplexing  grandmother  problem  in  the  person  of  the 
mother-in-law.  The  long,  long  needed  freedom  from  re- 
straints and  criticism  was  not  to  be  her  good  fortune.  She 
soon  became  convinced  that  she  was  not  regarded  with 
much  favor  by  the  older  woman  and  believed  that  her 
husband  favored  his  mother  in  their  conflicts,  which  he 
actually  did. 

The  psychoanalysis,  that  is  the  recall  in  detail  of  the 
images  (memories)  of  the  experiences  that  determined  her 
pathological  condition  required  about  eight  weeks  of  almost 
daily  conferences  averaging  more  than  an  hour  to  an  inter- 
view. The  recall  was  like  unraveling  a tangled  skein  of 
yarn.  Part  of  the  details  of  one  experience,  then  another, 
were  recalled  until  most  of  the  unpleasant  experiences  were 
related.  The  “jerking  spells”  and  “hatrish  feelings” 
bothered  her  the  most  and  naturally  her  discussion  of  her 
troubles  at  first  centered  about  their  description  and  onset. 
She  attributed  much  of  her  trouble  to  the  fact  that  several 
months  after  her  marriage  she  was  badly  frightened  by  a 
report  from  the  neighbors  that  an  insane  man  was  coming 
through  the  woods  towards  their  house.  The  next  day  their 
barn  caught  on  fire.  Although  she  was  menstruating  she 
ran  “about  a mile”  to  call  some  neighbors  and  while  on  her 
way  it  occurred  to  her  that  her  mother-in-law  might  enter  the 
barn  to  liberate  the  horses  and  be  burned  up.  She  promptly 
ran  back  to  the  house  and  found  that  an  excited  crowd  of 
neighbors  had  gathered  and  the  barn  was  in  ruins.  She 
recalled  how  she  cried  when  she  saw  the  remains  of  a pet 
colt  and  also  how  she  and  her  sister-in-law  prepared  a dinner 
for  the  neighbors,  and  when  they  entered  the  kitchen  her 
“head  flew  back”  and  her  “jaw  set.”  For  several  weeks 
she  seemed  to  be  unable  to  recall  any  other  details  of  this 
scene.  Later  when  the  house  caught  fire,  and  when  the 
wheat  field  burned  she  again  had  unusually  severe  convul- 
sions. 

Details  of  more  trivial  conflicts  about  the  conduct  of  the 
farm,  etc.,  seemed  to  force  themselves  into  the  foreground 
and  necessarily  had  to  be  readjusted  to.  Her  jealousy  of 
her  mother-in-law  became  very  evident,  and  her  incapacity 
to  meet  this  condition  troubled  her  greatly,  but  gradually 


Edward  J.  Kempf 


7 


she  developed  a determination  to  meet  her  family  problems 
on  another  basis  than  that  of  hatred.  This,  of  course,  she 
was  unable  to  really  carry  out,  but  her  attitude  had  the 
effect  of  enabling  her  to  study  her  troubles  more  intimately, 
and  she  no  longer  evaded  her  own  responsibilities  in  the 
psychoanalysis. 

Then  quite  unexpectedly  memory  details  or  images  of  a 
forgotten  traumatic  experience  came  to  the  surface  and 
proved  to  contain  the  determining  or  conditioning  stimuli 
of  her  very  distressing  gastric  sensori-motor  reactions  to  feel 
nauseated  when  red  fruits  or  vegetables  were  placed  on  the 
table  for  the  meal.  When  she  ate  the  red  fruits  or  vegetables 
they  were  quickly  emitted  again.  The  traumatic  incident 
amounted  to  the  following: 

In  June,  a few  months  after  their  marriage,  she  found 
her  mother-in-law  on  the  porch  before  breakfast  seeding 
cherries  for  canning  purposes.  The  patient,  who  was  trying 
to  take  charge  of  the  household,  made  preparations  to  help 
seed  the  cherries.  The  mother-in-law  refused  her  assistance. 
The  young  woman  persisted,  venturing  the  information  that 
she  was  not  unwell  because  her  mother-in-law  believed  that 
when  fruit  was  canned  by  a menstruating  woman  it  would 
spoil.  Although  her  menstrual  period  was  due  she  did  not 
realize  until  later  that  the  cause  for  its  seeming  delay  was 
pregnancy. 

For  several  minutes  she  was  unable  to  recall  anything 
further.  Finally  she  added,  “Then  I went  in  to  breakfast 
with  my  husband  and  tried  to  take  my  anger  out  on  him 
but  I got  no  satisfaction.”  Here  another  break  in  the 
recall  occurred.  Then  she  resumed,  “I  ate  a little  break- 
fast and  my  mother-in-law  brought  in  some  cherries.  I 
gave  my  husband  mine  with  the  remark  that  I guessed  they 
were  all  right  since  he  picked  them.  I left  the  table  and 
vomited  up  the  food.  I did  this  for  everything  I ate  after 
that  until  my  baby  was  born.  The  reason  I was  so  angry- 
was  because  we  had  contracted  to  run  the  farm  for  half  and 
I thought  I should  have  something  to  say.”  (She  discussed 
this  scene  with  free  expressions  of  anger  for  the  mistreat- 
ment.) 

(Cannon  has  shown  that  anger  or  fear  arousing  stimuli 


8 


A Study  of  the  Anaesthesia , Etc.,  of  Mrs.  V.  G. 


cause  a marked  disturbance  of  the  gastric  sensori-motor 
and  secretory  functions,  and  the  feelings  produced  by  the 
reaction,  according  to  James,  constitute  in  large  part  the 
emotion.  The  anger  and  fear  reactions  of  the  stomach 
both  seem  to  be  unsuitable  for  the  reception  of  food.) 
When  the  patient  was  still  further  aggravated  by  the  trium- 
phant mother-in-law  (primary  stimulus)  offering  the  cherries, 
(conditioning  stimulus)  theobject  of  the  conflict,  and  her 
husband  supported  his  mother,  the  patient  was  left  no 
outlet  upon  which  to  express  her  anger  and  make  a com- 
fortable readjustment.  She  had  to  control  herself,  that  is, 
suppress  the  affect.  Anger  tends  to  remove  the  stimulus 
from  the  receptor  and  not  to  accept  it,  much  less  to  swallow 
it  as  food.  She  succeeded  in  rejecting  the  cherries  but  the 
rage  status  of  the  stomach  was  unfit  to  retain  the  breakfast 
and  caused  feelings  of  nausea.  The  stomach  emitted  the 
food  and  it  seems  that  so  long  as  she  was  unable  to  make 
a normal  affective  adjustment  to  the  conditioning  or  primary 
stimuli  they  tended  to  arouse  reactions  of  hatred  and 
aversion.  When  she  did  make  a healthful  adjustment  to 
the  experience  the  affective  reenforcement  of  the  condi- 
tioned gastric  reflexes  no  longer  existed  and  it  seems  that 
concomitantly  the  gastric  reflexes  were  no  longer  conditioned 
to  react  with  aversion  to  the  particular  food.  (Perhaps 
a future  insight  into  such  functions  will  preclude  the  pres- 
ent tendency  to  discuss  the  conditioned  reflex  and  its  affec- 
tive reenforcement  as  separate  phenomena.) 

The  tendency  to  vomit  was  probably  reenforced  by 
the  aversions  to  food  which  occur  frequently  as  a psycho- 
genetic  phenomenon  in  pregnancy,  (perhaps  nourishing 
an  unwelcome  foetus)  because  throughout  pregnancy 
the  patient  vomited  nearly  all  the  food  she  ate.  and 
the  sight  of  red  fruit  on  the  table  caused  vomiting, 
whereas  after  her  labor  the  red  fruits,  etc.,  only  caused 
nausea  unless  they  were  eaten.  She  became  so  emaciated 
that  she  was  later  unable  to  nurse  her  baby.  The  very 
delicate  reactions  of  the  affections  to  stimuli  and  the  com- 
plicated nature  of  their  conditioning  deserves  the  exhaustive 
:study  of  psychology. 


Edzvard  J.  Kempf 


9 


The  tendency  to  react  with  aversion  to  all  red  fruits 
and  vegetables,  besides  cherries  was  probably  reenforced 
by  a traumatic  experience  of  several  months  previous, 
because  when  she  had  made  an  emotional  adjustment  to 
the  cherry  incident  and  expressed  her  hatred  for  the  husband 
and  mother-in-law  she,  much  to  my  surprise,  included  the 
pathologist.  She  could  not  explain  why  she  included  him 
until  it  occurred  to  her  that  she  felt  her  first  hatred  for  him 
when  he  removed  the  blood  (red)  stained  cloth  from  her  ear 
after  making  a puncture  to  take  a blood  specimen.  Then 
she  added  “I  thought  he  did  just  as  he  pleased.” 

Her  agitation  and  hatred  continued  for  the  next  twenty- 
four  hours  and  was  later  in  the  day  accompanied  by  con- 
vulsive jerkings  of  her  muscles  which  continued  throughout 
the  night. 

The  episode  of  the  cherries  occurred  after  the  barn  fire 
and  the  vividness  of  its  affective  impressions  had  probably 
covered  up  the  details  of  the  more  important  barn  fire 
episode.  Now  the  fire  episode  bothered  her  again  and  she 
made  considerable  progress  in  the  recall  of  its  details  but 
could  not  quite  get  all  of  it — the  most  pertinent  fact  in 
the  scene. 

She  visualized  the  fire  scene  in  greater  detail.  She  visual- 
ized how  the  excited  crowd  and  the  women,  particularly  the 
mother-in-law, (Mrs.  G.)  noticed  her  excitement  and  trembling 
and  told  her  to  keep  quiet  or  she  would  have  “spells”  like  her 
sister-in-law.  Here  a period  of  amnesia  occurred  but  she 
was  able  to  work  forward  from  the  time  her  head  “flew 
back”  etc.,  when  the  men  entered  the  kitchen.  One  of  the 
men  was  Mr.  H.  He  was  president  of  a home  insurance 
company  that  had  insured  this  barn.  Although  she  seemed 
to  be  unab.le,  with  persistent  effort,  to  recall  what  transpired 
between  the  suggestions  of  Mrs.  G.  and  the  entrance  of  Air. 
H.  she  was  able  to  develop  the  scene  from  the  time  of  his 
entrance  until  her  convulsions.  She  could  see  herself  trying 
to  pour  the  coffee  but  her  hands  trembled  so  violently  that 
her  sister-in-law  took  the  pot  and  “I  broke  down.”  She 
fell  back  into  a chair.  The  men  seized  her  arms  to  keep 
them  from  jerking  and  then  her  face  began  to  jerk  and  her 
jaws  set.  Then  her  entire  body  became  involved  in  a con- 


io  A Study  of  the  Anaesthesia , Etc.,  of  Mrs.  V.  G. 

vulsion  from  which  she  did  not  recover  until  the  next  day. 
She  had  always  been  apprehensive  lest  she  should  be  like  her 
sister-in-law  and  now  she  had  her  malady. 

Her  husband  paid  her  a visit  at  this  stage  of  the  analysis 
and  both  were  delighted  with  the  improvement.  She  said 
her  “mind  felt  free  and  open,”  and  she  now  understood  why 
she  had  attacks  in  the  presence  of  a crowd  or  a fire.  But 
it  soon  became  evident  that  she  was  not  so  well  as  she 
thought.  The  fire  scene  was  again  studied,  and  she  recalled 
more  elaborately  the  details  of  the  excited  crowd  running 
about  with  water,  and  that  Mr.  H.  wanted  to  know  who 
was  the  last  person  in  the  barn,  and  that  the  people  felt  sure 
that  the  son  of  the  insane  man,  who  had  been  in  the  woods 
the  night  before,  had  set  fire  to  the  barn  because  the  children 
reported  having  seen  him  running  away  from  the  fire.  The 
patient  heard  Mr.  H.  telephone  to  the  sheriff  to  arrest  the 
suspected  man.  This  recall  worried  her  and  she  expressed 
herself  that  “yesterday  I felt  so  good  and  now  I feel  as  if 
something  wants  to  come  out  and  can’t.  ” The  suspected 
man  was  a brother  of  her  girl  friend. 

She  seemed  unable  to  recall  anything  further  and  was 
very  much  agitated.  With  suggestions  that  she  would  see 
more  details  of  the  fire,  gradually  other  fragments  of  the 
scene  were  recalled.  She  now  saw  the  excited  Mr.  H.  with 
two  cups  of  water  trying  to  throw  them  on  the  fire  and  when 
he  entered  the  kitchen  doorway  she  started  to  tease  him 
about  it,  but  something  changed  her  mind.  After  several 
minutes  another  fragment  was  added.  She  saw  her  hus- 
band’s brother  J.  walking  behind  Mr.  H.  They  were  having 
an  earnest  conversation  and  then  she  remembered  that  she 
was  afraid  J.  was  talking  about  her  husband.  That  morning 
she  heard  J.  say  that  he  had  always  expected  a fire  because 
her  husband  would  not  stop  carrying  matches  when  in  the 
barn.  “Mr.  H.  had  a mean  look  in  his  eye  and  I thought 
J.  had  told  him  about  my  husband.  This  is  what  changed 
my  mind  and  I stopped  him  to  see  what  he  was  going  to  do.  ” 

No  further  recall  was  effected  although  we  tried  hard 
for  at  least  fifteen  minutes.  Then  she  had  a “strange 
thought.”  “Mrs.  T.,  an  old  lady,  set  fire  to  her  barn  when 


Eduard  J . Kempf  1 1 

she  smoked  in  it  and  Mr.  H.  refused  to  pay  her  the  insur- 
ance. ” 

With  this  fragment  it  seemed  obvious  that  the  patient 
held  a secret  which  Mr.  H.  should  know  and  was  afraid 
that  the  insurance  would  be  lost  if  he  knew  it.  I insisted 
that  she  knew  something  that  no  one  else  knew.  But  she 
seemed  to  be  unable  to  recall  anything,  and  was  obviously 
feeling  very  uncomfortable.  She  seemed  to  be  lost  in  study, 
then  suddenly  an  expression  of  decided  pleasure  swept  over 
her  features.  “I  knew  that  my  husband  watered  the  colt 
after  everybody  left  the  barn  that  morning  and  I thought 
he  might  have  fed  it  some  hay  and  dropped  some  matches. 
This  I was  afraid  Mr.  H.  would  find  out.  ” She  seemed  to 
feel'  an  immediate  relief  and  said  that  a weight  had  passed 
from  her. 

The  tendency  to  have  “jerking  spells,”  seemed  to  en- 
tirely disappear  and  she  regarded  herself  as  cured.  Several 
days  later,  however,  she  complained  of  spinal  pains  and  when 
examination  was  made,  much  to  my  surprise,  she  developed 
strong  rhythmical  jerks  of  the  recti  muscles  of  the  abdomen 
which  could  be  easily  seen  through  her  clothing.  Two  days 
later  a jealous  patient  made  offensive  statements  about  her 
and  her  physician,  and  following  this  conflict  the  recti 
muscles  resumed  a rhythmical  jerking  which  lasted  about 
36  hours.  Several  hours  of  interviews  did  not  yield  the 
slightest  information  relative  to  its  complex.  Her  difficul- 
ties with  this  patient  had  to  be  dealt  with  before  further 
progress  was  possible,  and  the  incident  emphasized  the 
importance  of  keeping  patients,  who  are  to  be  psycho- 
analyzed, in  a congenial  environment  and  free  from  in- 
quisitive or  critical  people. 

The  remainder  of  the  psychoanalysis  will  be  given  as 
compactly  as  possible  because  of  the  limited  space,  and  the 
traumatic  experience  will  be  related  in  brief  instead  of  in  the 
fragmentary  manner  of  the  recall.  She  was  finally  able  to 
place  the  first  attack  of  abdominal  jerking  as  having  occurred 
about  two  weeks  after  her  marriage,  and  later  she  recalled 
that  it  was  two  days  after  her  marriage  instead  of  two  weeks. 
The  difficulty  developed  as  follows:  The  night  following  her 
marriage  was  spent  in  revelry.  The  next  night  the  boys 


12  A Study  of  the  Anaesthesia , Etc.,  of  Mrs.  V.  G. 

carried  her  husband  away  and  the  following  afternoon  her 
husband  and  his  mother  paid  a visit  to  her  grandmother, 
despite  the  patient’s  objections,  and  she  refused  to  accom- 
pany them.  This  disregard  for  her  feelings  associated  the 
grandmother  and  mother-in-law  and  husband  against  her. 
This  disappointed  her  greatly  and  she  was  left  at  home  in  a 
very  unhappy  frame  of  mind.  Her  state  of  feeling  was 
probably  intense  indignation  and  hatred  for  the  grand- 
mother. She  said  she  was  lonely  and  cried.  She  had  no 
friend  and  no  one  to  depend  upon.  She  knew  nothing  about 
the  sexual  life  of  woman  and  was  afraid  of  becoming  preg- 
nant without  someone  to  take  care  of  her.  Her  sister-in- 
law’s  attacks  of  “jerking”  followed  the  birth  of  her  first  child, 
and  the  patient  believed  it  was  the  result  of  poor  treatment. 
This  reenforced  her  fears  of  pregnancy.  She  visualized 
herself  lying  on  the  bed  in  a very  morose  frame  of  mind. 
She  had  started  to  menstruate  that  day  and  that  night  she 
expected  to  sleep  with  her  husband.  She  was  disgusted 
with  her  condition  and  felt  deeply  disappointed  in  her 
husband’s  and  his  mother’s  attitude  toward  her  grandmother. 
She  had  expected  them  to  take  up  her  quarrel.  She  even 
regretted  her  marriage  and  thought  that  perhaps  she  had 
made  a mistake.  She  recalled  her  resolution  to  depend  upon 
her  sister-in-law  and  that  when  she  arose  from  the  bed  she  felt 
better  but  her  abdomen  jerked.  (It  always  seemed  to  me 
that  a critical  fragment  was  overlooked  here  unless  the 
sexual  transgression  occurred  in  the  afternoon  and  that  night 
also).  That  night  she  said  her  husband  “did  just  as  he 
pleased”  despite  her  unhappy  mental  state,  indignation  and 
resistance.  The  recall  of  this  imposition  seemed  to  com- 
plete the  details  of  the  repressed  traumatic  experience. 
Her  anger  at  the  pathologist,  who  “did  just  as  he  pleased" 
when  he  removed  the  blood  stained  cloth,  seemed  also  to  be 
explained.  Later  on  she  met  the  pathologist  again  and  told 
me  that  she  no  longer  hated  him  although  this  reaction  had 
persisted  for  weeks.  The  final  explanation  which  she  was 
able  to  give  for  the  abdominal  jerks  did  not  seem  definitely 
satisfactory  as  a traumatic  episode,  although  feelings  of 
shame  and  hatred  were  freely  expressed,  and  it  must  be 
included  that  because  of  her  disappointment  in  her  husband’s 


Edward  J.  Kemftf 


13 


loyalty  to  her  she  was  in  no  mood  to  make  love  to  him. 
Whatever  details  were  missing  seemed  to  be  unim- 
portant because  the  convulsions  entirely  disappeared,  in- 
cluding a tendency  to  squint  her  eyelids  closely  together 
and  avoid  looking  at  anyone  frankly.  Her  husband  had 
noticed  this  shifting  glance  on  a previous  visit  and  had 
asked  her  about  it. 

It  is  perhaps  necessary  to  repeat  that  she  recognized 
heat,  cold,  touch  and  pain  stimuli  over  the  left  half  of  her 
face,  left  breast  and  arm,  upper  back  and  posterior  arm 
surfaces  and  a narrow  strip  along  her  left  side  and  left  leg. 
The  right  side  of  the  face  and  body  was  almost  completely 
anaesthetic  except  that  sometimes,  upon  strong  reenforcing 
suggestions  that  she  could  feel  the  stimulus,  she  reacted. 
The  face  and  breast  lines  of  demarcation  were  definite  but 
the  other  borders  varied  several  inches  at  different  times. 
It  is  rather  striking  that  she  never  complained  of  areas  of 
anaesthesia  and  maintained  that  she  had  never  known  of 
their  existence  until  I discovered  them  in  the  routine  physical 
examination. 

The  time  and  manner  of  the  onset  of  the  anaesthesia 
was  quite  a dilemma.  The  anaesthesia  seemed  to  be  a 
discovery  for  her  and  she  did  not  have  the  slightest  idea 
how  it  might  have  occurred. 

In  a sense  the  associations  of  thought  that  led  up  to  the 
recall  of  the  painful  experience  were  influenced  by  me  in 
that  I insisted  that  through  the  areas  of  skin  which  she  avoid- 
ed the  recognition  of,  she  had  met  with  an  unpleasant  experi- 
ence. But  the  actual  details  of  the  recall  I am  sure  were 
not  changed  by  suggestions  because  when  in  our  groping 
for  the  experience  I told  her  that  I believed  it  must  have 
occurred  as  a result  of  her  husband’s  impositions  she  main- 
tained that  she  did  not  believe  it  had  any  relation  to  that 
experience  and  gave  it  little  consideration. 

After  a great  deal  of  searching  I rather  vigorously  in- 
sisted that  she  would  recall  some  things  that  would  lead  us 
back  to  the  time  of  the  experience.  After  considerable 
wandering  of  the  visual  images  she  recalled  the  scene  of  the 
engagement  conflict  with  the  grandmother  came  to  the  fore- 
ground. She  exhausted  the  details  of  the  unpleasant  an- 


14  A Study  of  the  Anaesthesia , Etc .,  of  Mrs.  V.  G. 

nouncement  of  her  engagement  and  the  scene  shifted  to  her 
imprisonment  in  her  bedroom.  Here  a gap  in  her  ability  to 
remember  occurred  and  she  was  not  able  to  recall  for  some 
time  the  slightest  detail  of  herself  in  the  room.  Then  she 
added  the  fragment  that  she  dressed  preparatory  to  elope 
from  the  house,  and  after  some  time  she  recalled  that  she 
changed  from  winter  to  spring  underwear.  Here  the  re- 
sistance became  so  strong  that  she  was  unable  to  make 
further  progress. 

I had  devoted  so  much  time  to  the  analysis  of  the  an- 
aesthesia complex  that  I again  felt  constrained  to  make  a 
suggestion  in  order  to  hasten  the  recall  of  the  details  of  the 
experience.  Obviously  the  traumatic  experience  occurred 
when  she  was  nude  and  since  the  door  was  locked  and  she 
was  alone  in  the  room  and  the  odd  distribution  of  the  anaes- 
thesia roughly  included  about  all  of  that  surface  of  the  body 
which  one  would  see  while  standing  in  a three-quarters  pose 
before  a mirror  I suggested  that  something  happened  while 
she  was  posing  before  the  mirror.  Had  this  anaesthesia 
been  merely  a wish  fulfillment  of  the  malingering  type  to 
gain  an  object,  as  is  still  ordinarily  believed  to  be  the  case 
in  hysteria  by  the  average  general  practitioner,  this  patient 
could  have  escaped  the  responsibility  by  simply  accepting 
my  suggestion.  But  it  was  not  correct  and  it  was  not  in 
her  power  to  change  her  functions  by  merely  wishing.  She 
simply  replied  that  although  she  did  not  know  what  the  true 
explanation  of  her  lost  sensation  was,  the  suggestion  I made 
did  not  feel  right. 

The  psychoanalysis  had  to  be  postponed  for  a week. 
When  she  entered  the  room  to  resume  the  analysis  she 
announced  rather  triumphantly  that  her  sensation  had  re- 
turned without  the  analysis.  Much  surprised  I asked  why 
she  thought  this.  She  said  she  could  no  longer  wash  the 
dishes.  Because  she  had  l^een  able  to  endure  hotter  water 
than  the  other  patients  she  had  been  delegated  to  wash  the 
dishes,  but  now  the  water  burned  her  hands.  I tested  her 
with  a pin  and  found  her  to  be  very  sensitive  where  previous- 
ly she  had  been  anaesthetic.  The  hypersensitiveness  was 
as  pathological  as  the  anaesthesia  had  been,  and  it  soon 
proved  that  she  had  recalled  most  of  the  traumatic  experi- 
ence of  which  she  was  ashamed  but  had  not  adjusted  to  it. 


Edward  J.  Kempf 


15 


In  brief,  while  locked  in  the  bedroom  she  had  had  a 
good  cry  and  time  to  think  things  over.  She  must  either 
marry  the  grandmother’s  choice  (Mr.  A.)  or  escape.  She 
was  facing  the  crisis  of  her  life  under  most  confusing  cir- 
cumstances. She  was  not  absolutely  sure  she  loved  the 
Protestant  (Mr.  G.)  but  she  had  more  confidence  in  him 
than  in  Mr.  A.  She  was  inclined  to  elope  and  marry  G.  and 
while  in  this  vacillating  frame  of  mind  she  changed  clothing. 
She  recalled  that  while  she  was  undressed  the  postman 
whistled  his  announcement  of  having  mail  for  the  house. 
She  was  expecting  a letter  from  A.  in  which  he  would  declare 
his  feelings  about  the  marriage.  She  liked  him  because  he 
was  bold  with  women  and  knew  more  about  the  world  than 
G.,  who  was  quiet  and  more  retiring.  Then  she  recalled 
parting  the  curtains  slightly  and  looking  out  of  the  window 
to  see  whether  or  not  the  postman  was  coming  into  their 
yard  and  watching  him  go  around  the  house.  She  remained 
there  for  some  time  lost  in  sexual  fancies  about  A.,  and 
whether  or  not  to  elope  with  G.,  and  did  not  hear  her  grand- 
mother come  upstairs.  Suddenly  she  was  aroused  from  her 
sensuous  day  dream  by  the  grandmother  pushing  a letter 
under  the  door.  She  was  startled  and  deeply  embarrassed 
because  of  her  sense  of  guilt,  her  nakedness  and  telltale 
sensuous  fancies  and  secret  planning  to  elope.  She  thought 
her  grandmother  was  opening  the  door  but  the  old  woman 
went  away  without  doing  so  or  saying  anything.  (The 
recall  of  the  surprise  came  only  after  great  resistance  and 
mortification.) 

The  patient  explained  that  she  was  nude  when  she  was 
surprised  except  for  the  curtain  that  she  was  peeping  through. 
It  covered  one  side  of  her  face,  shoulder,  breast  and  arm  and 
a strip  along  the  side  of  her  body  to  the  ankles.  Anaesthesia 
for  the  rest  of  the  body  resulted  from  a pathological  effort 
not  to  recognize  the  nudeness.  When  I asked  why  her 
back  was  not  affected  she  replied  that  perhaps  it  was  be- 
cause she  was  not  ashamed  of  her  back.  (Naked  backs  are 
permitted  on  the  stage.) 

Her  reactions  to  heat,  cold,  touch  and  pain  stimuli  now 
became  normal,  except  for  a small  area  of  anaesthesia  in- 
voving  the  upper  right  face  about  the  eye,  cheek  and  upper 


16  A Study  of  the  Anaesthesia , Etc.,  of  Mrs.  V . G. 

lip.  As  an  explanation  for  this  she  comparatively  easily 
recalled  a scene  in  which  A.  caught  and  kissed  her  despite 
her  resistance.  The  anaesthetic  area  was  where  he  kissed 
her.  The  repressed  affect  was  shame  and  indignation. 

Up  to  this  time  the  patient  consistently  maintained 
that  the  two  similar  blotches  of  erythema  on  the  extensor 
surfaces  of  each  forearm  resulted  from  an  incurable  skin 
disease  that  she  had  had  for  a year  or  more.  Although  she 
had  excellent  insight  into  her  psychoneurosis  she  would  not 
consider  the  blotches  on  her  arms  as  anything  but  a skin 
disease.  She  had  gained  in  weight  and  was  now  in  excellent 
physical  condition.  Hours  of  exposure  to  the  sun  in  the 
park  had  tanned  her  forearms  a very  noticeable  brown  but 
the  areas  of  capillary  dilatation  did  not  tan  and  remained 
decidedly  paler. 

She  was  now  much  more  inclined  to  scratch  her  fore- 
arms, at  times  she  almost  scarified  her  skin.  The  itching  now 
occupied  most  of  her  attention  and  she  complained  that 
she  could  not  go  into  the  park  because  the  grass  caused  her 
arms  to  itch,  and  this  feature  influenced  her  to  study  the 
difficulty.  I thought  the  itching  and  capillary  dilatation 
was  determined  by  one  experience  since  it  seemed  part  of 
the  same  skin  area  although  she  scratched  more  of  the  arm 
than  the  surface  of  the  blotches. 

Her  associations  of  thought  suggested  by  the  symptoms 
brought  up  a visual  picture  of  herself  working  in  the  garden 
with  her  mother-in-law.  It  was  very  hot  and  because  of 
her  poorly  nourished  condition  and  pregnancy  the  mother-in- 
law  told  her  to  go  into  the  house.  They  had  been  pulling  a 
weed  that  had  caused  her  skin  to  itch.  She  felt  that  the 
mother-in-law  was  trying  to  command  her,  and  she  refused 
but  retired  to  the  shade  of  an  apple  tree.  She  visualized 
herself  standing  there,  rubbing  her  itching  arms  and  feeling 
very  angry.  The  mother-in-law  persisted  and  she  finally 
submitted  and  retired  to  the  house.  She  hated  the  mother- 
in-law  for  bossing  her  but  repressed  her  feelings.  She  made 
a comfortable,  affective  readjustment  to  this  experience  by 
a discussion  of  her  mother-in-law  and  the  itching  disappeared, 
but  the  blotches  of  skirt  did  not  tan. 


Edward  J.  Kempf 


1 7 


The  queer  distributions  of  the  blotches  of  erythema 
suggested  the  grip  of  someone’s  hands  to  me,  which  I dis- 
cussed when  I showed  them  to  another  physician  and  the 
patient  probably  remembered  this,  although  at  the  time  she 
did  not  agree  with  me. 

The  associations  of  thought  may  possibly  have  been 
influenced  by  that  conference  but  I believe  it  is  impossible 
for  a patient  to  relieve  a repression  symptom  by  telling  a 
lie  or  substituting  an  irrelevant  experience.  She  visualized 
herself  in  a room  with  her  mother-in-law.  She  had  an- 
nounced that  she  was  going  to  harness  the  horse  and  drive 
to  town.  The  mother-in-law  opposed  this  and  a conflict 
resulted.  The  patient  started  to  leave  the  house  and  her 
mother-in-law  grabbed  her  by  the  forearms.  The  patient 
jerked  loose  and  the  tightly  compressed  fingers  slipped  off 
leaving  the  dilated  capillary  blotches  where  the  fingers  had 
compressed  the  skin.  The  recall  of  this  experience  was 
accompanied  with  its  repressed  affect  of  hatred  and  she 
expressed  herself  freely  about  the  forgotten  experience.  In 
each  of  the  instances  of  repressing  her  hatred  she  gave  as 
the  reason  her  utter  dependence  upon  the  mother-in-law 
and  her  fear  of  offending  her. 

Unfortunately  the  patient  was  discharged  about  a week 
later  and  I was  unable  to  observe  that  the  pale  blotches 
tanned  as  much  as  the  remainder  of  the  arm  although  they 
were  quite  brown  in  comparison  to  their  former  condition 
and  had  practically  disappeared.  The  erythema  and  itching 
had  completely  disappeared. 

It  was  necessary  for  the  patient  to  get  some  insight  into 
her  serious  tendency  to  repress  her  strong  affective  reactions 
of  hatred  and  her  grave  persistent  feelings  of  inferiority. 
She  was  decidedly  immature  in  her  self-reliance.  She  be- 
lieved her  grandmother  had  ruined  her  life  by  the  kidnapping 
and  mistreatment,  and  insisted  that  she  had  never  had  a 
childhood  sexual  trauma.  (At  the  time  of  this  psycho- 
analysis the  psychogenetic  importance  of  the  autoerotic 
and  homosexual  strivings  were  not  realized  and  so  were 
overlooked.)  She  recalled  that  she  did  not  like  a certain 
girl  and  her  brother  after  she  had  grown  up,  although  they 
were  her  playmates  when  they  were  children.  She  finally 


1 8 A Study  of  the  Anaesthesia , Etc.,  of  Mrs.  V.  G. 


associated  with  this  dislike  a scene  of  her  childhood  when 
an  attempt  was  made  by  this  boy  to  perform  sexual  inter- 
course with  her  and  his  sister.  He  was  considerably  older 
and  he  with  his  sister,  who  was  about  -her  age,  enticed  her 
to  submit  to  the  play.  While  they  were  in  the  act  her 
foster-mother  surprised  them  and  whipped  the  patient. 
More  serious  than  the  whipping,  she  caused  the  child  to  feel 
that  she  had  lost  confidence  and  respect  for  her. 

This  sexual  trauma  cannot  be  considered  the  foundation 
of  her  psychoneurosis  but  it  probably  played  a part  as  a 
determinant  of  her  tendency  to  react  in  a repressive  manner 
to  her  conflicts,  and  tremendously  accelerated  the  tendency 
to  react  with  shame  to  even  trivial  mistakes.  The  long 
years  of  domination  by  an  unsympathetic  grandmother 
following  ten  years  of  petting  by  her  foster-mother,  her 
tendency  to  nurse  her  hatred,  and  even  enjoy  it,  associated 
with  her  serious  ignorance  of  the  sexual  life  of  woman  should 
be  considered.  She  married  to  escape  a domineering  grand- 
mother who  never  permitted  her  to  assert  herself  and  most 
unfortunately  became  associated  with  a still  more  domineer- 
ing mother-in-law.  The  psychoanalysis  of  the  case  cannot 
be  considered  finished  nor  the  patient  cured  of  her  psycho- 
pathic tendencies. 

Within  three  years  after  the  psychoanalysis  she  has 
written  in  reply  to  an  inquiry,  that  none  of  the  symptoms 
which  were  analyzed  returned,  but  she  has  had  at  least  one 
psychotic  episode  since  her  discharge,  the  details  of  which 
were  not  learned.  She  had  to  return  to  the  household  of 
her  mother-in-law. 

Probably  this  patient’s  unusual  tendency  to  form  one 
affective  repression  after  another  and  in  nearly  every  in- 
stance, that  of  hatred,  was  largely  the  result  of  her  affective 
isolation  in  her  grandmother’s  house.  Her  “ hatrish  feelings 
caused  her  often  to  entertain  revengeful  fancies,  which  un- 
doubtedly she  really  enjoyed  and  then  regretted.  (These 
fancies  were  her  only  avenue  of  escape  from  the  unusually 
inflexible,  painful  environment.) 

That  her  personality  never  developed  beyond  the 
autoerotic  level  was  probably  due  to  the  consistent  re- 
pressive influence  of  the  dominating  grandmother  who 


. Edward  J.  Kempf 


T9 


assiduously  imposed  a censorship  upon  most  of  her  spontan- 
eous girlish,  social  interests  and  forced  the  child  with  threats 
of  punishment  to  suppress  her  emotions. 

She  really  married  to  escape  from  her  grandmother  and 
unfortunately  moved  into  the  house  of  her  mother-in-law. 
Because  of  her  long  training  to  repress  her  affections,  to  be 
economically  dependent,  to  have  a grossly  apprehensive 
misunderstanding  of  the  sexual  life  of  woman,  her  deficiencies 
became  the  instruments  that  bound  her  to  the  older  woman. 
She  dared  not  retaliate  and  offend  her  mother-in-law  for 
fear  of  being  neglected  in  her  pregnancy  and  labor. 

Discussion. 

In  this  case,  in  each  instance  of  affective  repression 
that  left  objective,  functional  derangements,  the  affect  was 
the  natural  response  to  a definite  situation,  that  is,  a healthy 
response  to  the  situation,  but  was  repressed  because  of  some 
form  of  fear  of  the  consequences  if  she  should  permit  her 
feelings  free  play.  In  each  instance  the  initial  affective  re- 
action, whether  shame  or  hatred,  may  be  looked  upon  as  a 
normal  reflex  response  to  certain  features  in  a definite  situa- 
tion and  these  features  may  be  regarded  as  the  primary 
stimulus  of  the  affective  reaction.  Associated  simultaneous- 
ly with  the  primary  stimulus  were  stimuli  that  had  previous- 
ly been  indifferent  in  so  far  as  affective  reactions  were  con- 
cerned. To  illustrate  this,  let  us  take  the  itching  or  erythema 
symptoms. 

The  dominance  of  the  mother-in-law,  with  her  affective 
attitude  and  words,  was  the  primary  stimulus  of  the  natural 
affective  reaction  of  hatred  in  the  patient.  The  itching  of 
the  skin  from  an  irritating  weed,  which  occurred  at  the  time, 
or  the  capillary  dilatation  of  the  skin  from  compression  and 
friction  of  the  fingers,  were  normal  reactions  to  stimuli  which 
were  heretofore  indifferent  to  affective  reactions  of 
hatred.  Through  the  accidental  association  as  simultaneous 
stimuli  of  these  primary  affective  and  the  indifferent 
stimuli  which  were  causing  the  most  vigorous  reactions  of  the 
organism  at  the  time , the  affective  reactions  became  conditioned 
to  react  to  these  indifferent  stimuli.  This  continued  so  long  as 


20  A Study  of  the  Anaesthesia , Etc.,  of  Mrs.  V.  G. 

the  affective  reactions  were  repressed  and  apparently  they 
reenforced  the  normal  reactions  to  the  indifferent  stimuli 
and  made  the  reactions  persist  for  undue  periods  of  time.  The 
memories  of  the  experience  were  repressed  (forgotten)  and 
the  individual  reacted  with  hatred  and  itching  when  in  the 
grass  without  knowing  that  it  was  caused  by  the  grass. 
Later  when  she  knew  that  the  grass  caused  the  itching  it 
did  not  enable  her  to  stop  the  reactions.  In  each  instance, 
after  the  repressed  affect  was  allowed  to  have  its  normal 
play  and  an  adequate  affective  readjustment  to  the  situation 
was  made,  the  pathological  influence  of  the  indifferent 
stimuli  and  the  objective  symptoms  disappeared. 

Bechterew  first  pointed  out,  and  has  been  supported 
by  the  studies  of  Watson  and  Lashley,  that  when  the  primary 
stimulus  of  a motor  or  secretion  reflex  is  associated  simul- 
taneously for  a number  of  times  with  an  indifferent  stimulus 
then  the  reflex  will  become  conditioned  to  react  to  the  in- 
different stimulus.  This  seems  to  be  the  mechanism  of 
psychoneuroses  except  when  the  affective  reenforcement 
is  vigorous  enough,  then  one  simultaneous  association  may 
be  sufficient. 

Bechterew  further  pointed  out  that  when  reflexes 
become  thoroughly  conditioned  to  react  to  certain  stimuli, 
they,  like  the  reaction  to  primary  stimuli,  may  become  the 
root  upon  which  are  grafted  the  influence  of  other  condition- 
ing stimuli. 

In  this  patient  the  sequence  of  development  of  the 
symptoms  suggests  very  strongly,  since  nearly  all  were  re- 
enforced by  repressions  of  shame  or  hatred,  that  they  were  in- 
timately associated  together  like  grafted  branches  to  a seriously 
growing  biological  tendency.  First  a petted,  timid,  sensitive 
child  was  surprised  in  sexual  play  and  her  conduct  severely 
reprimanded  as  shameful.  At  ten  she  was  kidnapped  by  an 
unsympathetic,  domineering  grandmother  who  tended  to 
persistently  injure  the  child’s  feelings  and  force  her  to  sup- 
press her  anger.  The  child’s  fear  of  the  grandfather  at 
night  certainly  indicates  the  early  pathological  adaptations 
of  her  sexual  life.  The  repressions  of  shame  and  the  anaes- 
thesia occurred  with  her  engagement  experiences.  The  first 
motor  disturbances  developed  within  two  days  after  her  mar- 


Edward  J.  Kemp] 


21 


riage  reenforce  by  repressions  of  hatred  and  shame.  A few 
months  later  upon  this  was  engrafted  or  associated  general  mo- 
tor convulsions  reenforced  by  suggestions  and  repressions  of 
shame.  Within  a short  time  she  developed  a- pathological 
nausea  and  vomiting  as  the  result  of  her  repressions  of  anger 
in  an  experience  and  then  repressions  of  hatred  reenforced 
persistent  sensations  of  itching  and  an  erythema,  visual  con- 
striction for  the  right  eye  particularly  for  red, and  intense  aver- 
sion for  her  husband,  mother-in-law  and  grandmother.  Her 
hatred  for  the  pathologist,  which  was  aroused  through  his 
work  being  accidentally  associated  by  its  similarity  (the 
blood  stained  rag)  with  the  conditioning  stimulus  of  previous 
repressions  of  hatred,  is  an  example  of  how  peculiarly  fea- 
tures in  the  hospital  may  become  seriously  involved  in  the 
patient’s  difficulties. 

The  affective  reactions  of  hatred  and  its  need  of  in- 
juring the  cause  of  the  hatred  were  repressed  by  the  fear 
of  doing  something  which  would  be  regretted.  The  con- 
flicts were  always  intense  and  acute,  necessitating  vigorous 
efforts  to  repress  from  consciousness  the  memories  that 
aroused  the  hatred  or  shame.  The  successful  repression 
depended  upon  the  patient's  ability  to  immediately  coordinate 
all  her  attention  upon  a substitute , and  this  substitute  was 
very  naturally  that  content  of  consciousness  which  zvas  next 
most  vivid  at  the  moment  of  the  affective  conflict. 

This  case  seems  to  offer  an  explanation  of  the  phenom- 
enon of  visual  constriction — namely,  through  an  affective 
resistance  the  threshold  of  consciousness  is  so  heightened 
that  only  the  more  sensitive  receptors  which  lie  approximate- 
ly nearest  the  macula  will  transmit  sensory  reactions  of 
sufficient  intensity  to  produce  consciousness  of  them.  The 
stimuli  that  arise  from  objects  in  the  peripheral  field,  the 
intensity  of  the  light  waves  being  equal,  since  they  must 
play  upon  the  less  sensitive  receptors,  cause  subliminal  re- 
actions to  the  affective  resistance.  Therefore  only  the 
colors  directly  before  the  eye  are  seen.  Theoretically  the 
affective  resistance  may  become  so  vigorous  that  complete 
anaesthesia  or  blindness  may  result  and  no  stimuli  may  be 
intense  enough  to  break  through  the  resistance. 


22 


A Study  of  the  Anaesthesia , Etc.,  of  Mrs.  V.  G. 

t 

Functional  deafness,  anosmia,  loss  of  taste  etc.,  may 
also  be  forms  of  anaesthesia  or  heightened  thresholds  of 
consciousness  because  of  affective  resistances. 

In  the  case  of  Miss  Lucy  R.,  Freud  says  “The  hysteri- 
cal form  of  defence,  for  which  a special  adaptation  is  required, 
consists  in  converting  the  excitement  into  physical  inner- 
vation. The  gain  brought  about  by  this  process  is  the 
crowding  out  of  the  unbearable  presentation  from  the  ego 
consciousness,  which  then  contains  instead  the  physical  rem- 
iniscences produced  by  t-he  conversion — in  our  case  the 
subjective  sense  of  smell — and  suffers  from  the  effect  which 
is  more  or  less  distinctly  adherent  to  these  reminiscences.” 

It  is  necessary  to  briefly  restate  the  manner  in  which 
Miss  Lucy  R.  developed  the  persistent  olfactory  image  of 
cigar  smoke  which  annoyed  her  so  much. 

She  loved  her  master’s  children  and  had  encouraged 
herself  to  expect  the  love  of  her  widowed  master  and  was 
shocked  when  one  day  he  unjustly  threatened  to  discharge 
her  if  strangers  were  again  permitted  to  kiss  his  children. 
A few  months  later  when,  she  was  coincidentally  suffering 
from  caries  of  the  ethmoid,  after  a dinner  an  elderly  guest 
attempted  to  kiss  the  children,  the  impetuous  master  shouted 
“Don’t  kiss  the  children!”  she  “experienced  a stitch  in  the 
heart,  and  as  the  gentlemen  were  smoking,  the  odor  remained 
in  my  memory.  ” 

The  violent  words  of  the  master  were  sufficient  as  a 
primary  stimulus  of  reactions  of  fear  (because  of  the  pre- 
viously threatened  discharge)  to  force  a repression  of  her 
affections  for  the  children  and  master  since  it  was  not  pos- 
sible in  the  situation  for  a governess  to  permit  the  natural- 
ly anxious  expression  of  her  endangered  affections  for  the 
children — and  her  master.  Because  of  her  affective  attach- 
ment her  position  had  a vital  value  for  her.  She  held  the 
attachment  by  a slender  thread  in  the  hands  of  an  impet- 
uous master,  who  had  already  threatened  to  break  it  if 
a pertain,  almost  unavoidable,  trivial  incident  should  occur 
again.  In  his  discussion  Freud  does  not  seem  to  think  that 
the  fear  of  the  discharge  was  justifiable  for  the  affective  re- 
pression, and  that  a degree  of  moral  courage  was  lacking  in 
his  patient.  I cannot  at  all  agree  with  Freud’s  feelings.  It 


Edward  J.  Kempf 


23 


seems  to  me  that  the  patient’s  affective  attachment  (mater- 
nal) to  the  children  made  her  unfortunately  but  normally 
a weakling  in  the  face  of  a discharge. 

Now  to  return  to  the  “conversion.”  It  seems  to  me 
that  this  conception  of  conversion  is  not  satisfactory  as  a 
conceptionof  the  biological  process  and  the  “special”  defensive 
adaptation  of  “converting  the  excitement  into  physical  in- 
nervation” is  a biological  riddle.  Just  how  Freud  understands 
that  excitement  may  be  converted  into  a physical  inner- 
vation is  not  intelligible.  Furthermore  it  seems  to  me  that 
this  conversion  conception  is  the  keystone  of  Freud’s  im- 
portant but  not  quite  satisfactory  libido  concept.  I 
believe  the  persistent  olfactory  image  of  tobacco  smoke 
complained  of  by  Miss  Lucy  R.  was  an  example  of  the  re- 
pressed affective  reactions  becoming  conditioned  to  react  to 
an  ordinarily  indifferent  stimulus  (cigar  smoke)  and  the  ol- 
factory image  was  made  so  persistent  by  the  repressed  but 
active  affections  forcing  awareness. 

In  the  instant  of  that  conflict  the  affective  processes  of 
love  for  the  children  were  repressed  by  fear  and  continued 
to  remain  repressed  until  Freud  released  them  by  analyzing 
away  the  fear.  To  make  the  repression  and  avoid  showing 
the  anxiety  of  losing  the  objects  of  her  affections,  the  organ- 
ism, as  a biological  unity,  reflexly  co-ordinated  all  its  avail- 
able forces  upon  the  control  of  the  final  common  path  of 
expression  which  was  the  next  most  vivid  sensory  reaction 
at  hand,  namely,  the  cigar  fumes  which  were  coincidentally 
irritating  the  diseased  nasal  membranes  and  causing  discom- 
fort. 

The  reflex  adapatations  to  the  nasal  irritation,  because 
of  their  simultaneous  activity,  became  associated  with  the 
normal  affective  reactions  to  the  primary  stimulus  of  anxiety, 
namely,  the  irritated,  impulsive  master.  When  Freud 
analyzed  away  the  fear  and  permitted  the  affective  re  n- 
forcement  of  the  persistent  olfactory  images  to  make  an 
adequate  readjustment  to  the  violent  stimulus  and  its 
implications  (“Don’t  kiss  the  children,”)  then  the  sensory 
images  lost  their  vividness  and  took  their  normal  place  in 
the  sensory  experiences  of  the  personality. 


24  A Study  of  the  Anaesthesia , Etc.,  of  Mrs.  V.  G. 


Conclusions 

Psychoneuroses  are  conditioned  reflex  activities  and 
are  pathological  because  the  affections  have  become  condi- 
tioned through  experiences  to  react  to  stimuli  that  normally 
should  have  an  indifferent  influence. 

The  persistence  of  the  abnormal  conditioning  of  the 
reflex  is  due  to  the  reenforcement  by  repressed  affections 
which  disappear  as  a reenforcement  so  soon  as  an  adequate 
affective  readjustment  is  made. 

Fear  of  allowing  the  primary  affections,  whether  of  shame, 
hatred,  grief  or  love,  adequate  expression  tends  to  make  a psy- 
chopath of  any  individual;  that  is  to  say  when  the  affections  of  a 
personality  are  repressed  their  functions  are  abnormal. 

BIBLIOGRAPHY 

Bechterew — La  Psychologie  Objective.  Chapter  IX. 
Watson,  J.  B. — The  Place  of  the  Conditioned  Reflex  in 
Psychology.  Vol.  XXIII — No.  2,  Psychological  Re- 
view. 

Watson,  J.  B. — Behavior  and  the  Concept  of  Mental  Dis- 
ease. Vol.  XIII,  No.  22,  The  Journal  of  Philosophy, 
Psychology  and  Scientific  Methods. 

Lashley — The  Human  Salivary  Reflex  and  Its  Use  in  Psycho- 
logy. Vol.  VIII,  No.  6,  Psychological  Review. 

Freud,  S. — Selected  Papers  on  Hysteria  and  Other  Psycho- 
neuroses. Page  28.  The  case  of  Miss  Lucy  R.  (Trans- 
lated by  A.  A.  Brill.) 


SOME  ANALYSES  IN  THE  PSYCHOPATHOLOGY  OF 
EVERYDAY  LIFE 


BY  H.  W.  FRINK,  M.  D. 

Instructor  in  Neurology  and  Chief  of  the  Neurological  Clinic 
Cornell  Medical  College , New  York. 

AS  Freud  has  shown  in  his  Psychopathologie  des 
Alltagslebens , those  small  disturbances  of  mental 
functioning  such  as  slips  of  speech,  mistakes  in 
writing,  the  occasional  forgetting  of  familiar  names, 
etc.,  are  not  mere  chance  happenings  but  have  their  definite 
determinants.  In  almost  every  instance  it  can  be  demon- 
strated by  careful  investigation  that  the  disturbance  was 
brought  about  by  the  influence  of  some  stream  of  thought 
or  group  of  ideas  which  for  the  time  being  lay  outside  the 
field  of  the  individual’s  consciousness.  These  side  streams 
are  not  very  far  removed  from  consciousness,  in  perhaps 
the  majority  of  instances.  They  belong  rather  to  the  fore- 
conscious than  to  the  unconscious  proper,  and  thus  are 
usually  quite  accessible  to  conscious  introspection. 

The  disturbances  of  functioning  produced  by  these 
foreconscious  or  unconscious  trends  are  brought  about  in 
different  ways.  Sometimes  the  malfunctioning  expresses 
the  fulfillment  of  a pleasure-striving;  at  others  it  represents 
a defense  against  a painful  trend  or  idea,  etc.  In  any  case 
the  disturbance  is  one  which,  upon  analysis,  may  be  ex- 
pressed in  terms  of  motive  and,  in  miniature,  is  identical  in 
psychological  structure  with  those  greater  disturbances 
which  we  know  as  psychoneurotic  and  psychotic  symptoms. 
The  difference  between  the  “psychopathology  of  everyday 
life”  and  actual  psychopathology  or  psychic  illness  is,  in 
essence,  merely  a quantitative  one. 

Perhaps  the  most  common  example  of  these  minor 
disturbances  is  that  of  temporary  inability  to  recall  some 
perfectly  familiar  word  or  name.  Lapses  of  memory  of 


25 


26  Some  Analyses  in  the  Psychopathology  of  Everyday  Life 

this  variety  are  usually  found  upon  analysis  to  be  phenomena 
of  defense.  The  name  or' word  is  one  which  was  included  in 
or  closely  associated  with  a group  of  ideas  painful  to  the 
conscious  personality  of  the  individual  and  which  in  con- 
sequence had  been  included  within  the  protective  resistances 
tending  to  oppose  the  entrance  of  these  painful  ideas  into 
consciousness.  The  examples  which  follow  are  sufficiently 
understandable  without  further  introduction. 

I.  A friend  once  asked  me  if  I knew  of  a firm  which  could 
supply  a certain  commodity  he  desired,  but  upon  replying 
that  I did,  I found  myself  unable  to  remember  the  name  of 
the  firm,  although  I did  remember  the  location  of  their 
place  of  business — a large  downtown  office  building. 

A few  days  later,  as  I happened  to  be  passing  this 
building,  I stepped  in,  and  upon  consulting  the  directory 
of  its  tenants  found  that  the  name  I had  been  unable  to 
recall  was  Pond.  I attempted  afterward  to  analyze  my 
forgetting  with  the  results  that  are  here  recorded. 

My  first  association  with  the  word  Pond  was  that  a 
certain  Dr.  Pond  had  been  a pitcher  on  the  old  Baltimore 
baseball  team.  Next  I thought  of  Indian  Pond,  where  I 
used  to  go  fishing  as  a small  boy,  and  I had  a memory  picture 
of  myself  throwing  into  the  water  the  large  stone  used  as  an 
anchor  for  the  boat.  Then  I thought  of  a man  named 
Fischer  who  is  at  present  a pitcher  for  the  New  York  Ameri- 
cans. 

Continuing,  I thought  of  Pond’s  Extract  and  of  the 
fact  that  it  contains  witch  hazel.  This  reminded  me  that  I 
used  witch  hazel  to  rub  my  arm  when  in  my  school  days  I 
was  pitcher  on  a baseball  team.  I also  thought  of  a certain 
fat  boy  who  was  a member  of  the  same  team  and  recalled 
with  amusement  that  in  sliding  to  a base  this  boy  once  went 
head  first  into  a mud  puddle,  so  that  as  he  lifted  his  face 
plastered  with  dirt  this,  combined  with  his  marked  rotundity, 
had  given  him  an  extremely  laughable  and  pig-like  appear- 
ance. I further  recalled  that  at  that  time  I knew  a boy' 
nicknamed  “Piggy”  and  that  at  a later  time  I had  been 
nicknamed  “Pig.” 


H.  W.  Frink 


27 


At  this  point  I was  interrupted  for  a few  moments,  and 
when  I returned  to  the  analysis  the  word  Pond  brought  the 
associations:  Ponder — think — “sickbed  o’er  with  the  pale 
cast  of  thought” — Hamlet — the  memory  of  my  having  re- 
ferred to  a certain  village  as  a hamlet — the  recollection  that 
a farmer  in  this  village  once  told  me  that  a spiteful  neighbor 
killed  two  pigs  and  threw  them  into  his  (the  farmer’s)  well. 

Then  there  suddenly  occurred  to  me  the  following 
incident  from  my  seventh  year,  which  appears  to  have  been 
the  cause  of  my  forgetting  the  word  Pond. 

At  the  time  I refer  to  I had  a dog  to  which  I was  greatly 
attached.  My  brother  and  I were  playing  one  day  on  the 
edge  of  a small  pond  near  our  house,  and  this  dog  was  in  the 
water  swimming.  We  began  to  throw  small  stones  into  the 
water  in  front  of  the  dog,  and  as  each  stone  struck  the  surface 
he  would  jump  for  the  splash,  try  to  bite  it,  and  bark  in 
joyous  excitement.  Finally,  I was  seized  with  the  malicious 
desire  to  scare  the  dog  and,  picking  up  a stone  weighing  three 
or  four  pounds,  I threw'  it,  intending  it  to  strike  just  in  front 
of  him  and  frighten  him  by  its  enormous  splash.  Un- 
fortunately, my  aim  was  bad.  The  big  stone  struck  the 
dog  squarely  upon  the  nose  and  stunned  him,  so  that  he 
sank  beneath  the  surface  and  was  drowned. 

My  grief  over  this  incident  was  without  question  the 
greatest  that  I experienced  in  my  childhood.  For  days  I w'as 
utterly  inconsolable,  and  for  a long  time  there  were  occasions 
wdren  I would  be  so  overcome  with  sorrow  and  remorse  as  to 
cry  myself  to  sleep  at  night.  I suppose,  however,  that  my 
grief  seemed  greater  than  it  actually  was.  That  is  to  say, 
it  was  exaggerated  to  serve  as  a compensation  and  penance 
for  the  painful  perception  that  a cruel  impulse  on  my  part 
was  responsible  for  the  dog’s  untimely  end. 

At  any  rate,  as  is  plain,  the  memory  of  the  incident  wras 
a very  painful  one,  and,  in  consequence,  I had  good  reason 
to  wish  to  forget  not  only  the  incident  itself  but  also  any 
word  (such  as  Pond)  which  might  serve  to  bring  it  before  my 
consciousness. 

A matter  that  is  not  without  interest  in  this  analysis  is 
the  relevancy  of  my  seemingly  irrelevant  associations.  For 
instance,  my  first  association — that  of  the  pitcher,  Dr. 


28  Some  Analyses  in  the  Psychopathology  of  Everyday  Life 

Pond — contains  three  ideas  connected  with  the  repressed 
memory;  viz.,  Doctor  (myself),  Pond  (the  place  of  the  inci- 
dent),  and  pitcher  (one  who  throws).  My  second  association 
■ — concerning  Indian  Pond  and  my  throwing  into  the  water 
the  big  stone  used  as  anchor — is  equally  relevant.  Indian 
Pond  is  in  the  same  town  as  the  other  pond  in  which  the 
dog  was  drowned;  my  memory  of  throwing  overboard  the 
anchor  is  connected  with  the  memory  of  throwing  into  the 
water  the  other  big  stone  which  caused  the  dog’s  death,  etc. 

The  association  pig  which  came  up  several  times  in  the 
latter  part  of  the  analysis  seern^  at  first  glance  to  have  no 
connection  with  the  concealed  memory.  A connection  does 
exist,  however.  The  letters  P-I-G  reversed  are  G-I-P,  which 
spells  the  name  of  the  dog.  Thus  the  association  concerning, 
the  pig-like  boy  and  the  mud  puddle — which  contains  the 
elements  P-I-G , baseball  (i.  e.,  throwing),  and  water — or  that 
of  the  farmer  and  the  pigs — P-I-G,  death,  throwing,  and 
water — is  seen  to  be  perfectly  relevant.  Hamlet  and  the 
quotation  from  it  gain  a mediate  relevancy  through  the 
drowning  of  Ophelia. 

II.  A friend  of  mine  who  lives  in  a suburb  of  New 
York  once  telephoned  me  to  go  to  dinner  and  the  theater 
with  him.  I met  him  as  he  suggested  and  during  the  con- 
versation at  dinner  he  said  jn  commenting  on  an  occurrence 
that  had  greatly  surprised  him,  “I  could  not  believe  the 
information  of  my  own  senses.”  “No,  that  isn’t  right;” 
he  went  on,  interrupting  himself,  “we  don’t  speak  of  doubt- 
ing the  information  of  our  senses — some  other  word  is  used. 
What  is  it?  The  reality  of  our  senses?” 

I replied  that  what  he  had  meant  to  say  was  that  he 
could  not  believe  the  evidence  of  his  senses,  and  asked, 
laughing,  “Why  do  you  want  to  fotget  about  evidence? 
You  haven’t  committed  a crime,  have  you?” 

“No,”  he  replied,  apparently  somewhat  startled,  “I 
haven’t  committed  any  crime,  but  I’m  afraid  I’m  about  as 
badly  off  as  if  I had  done  so.  It’s  quite  astonishing  how’  near 
you  came  to  the  truth.” 

He  then  went  on  to  explain  that  a woman  with  whom  he 
had  had  business  relations  over  quite  a long  period  had 


H.  W.  Frink 


29 


become  incensed  over  some  trifle  and  made  certain  unjust 
and  untrue  accusations  against  him,  which  she  threatened 
to  make  public  in  the  form  of  a suit.  He  had  felt  little 
concern  over  the  matter  until  there  suddenly  came  upon  him 
the  realization  that  if  she  did  carry  out  her  threat — a thing 
he  felt  she  was  quite  capable  of  doing — his  situation  would 
be  an  extremely  unpleasant  one,  for  not  only  had  he  no  way 
of  positively  disproving  her  allegations,  but  there  were 
certain  pieces  of  circumstantial  evidence  which  she  could 
bring  forward  and  which,  in  spite  of  his  actual  innocence, 
would  readily  create  against  him  a strong  presumption  of 
guilt.  Thus  the  situation  might  well  be  a serious  one  for 
him.  Naturally,  he  was  greatly  disturbed,  and  he  had  been 
worrying  about  evidence  and  proof  almost  to  the  point  of 
distraction.  At  last  he  angrily  told  himself  that  there  was 
nothing  to  be  gained  by  worry  and  that  the  best  thing  would 
be  to  put  the  matter  out  of  mind  until  the  woman  saw  fit  to 
make  some  definite  move.  With  this  end  in  view  he  jumped 
on  a train  and  came  to  New  York,  hoping  to  find  something 
to  divert  his  thoughts  to  more  pleasant  themes. 

His  failure  to  remember  the  word  evidence  as  a part  of 
the  familiar  phrase  he  wished  to  use  was,  as  may  now  be 
seen,  a part  of  the  more  or  less  automatic  defense  designed 
to  protect  against  reproduction  in  his  consciousness  of  the 
disagreeable  theme  .in  which  the  question  of  evidence  formed 
such  a conspicuous  part. 

III.  One  of  my  patients,  while  discussing  baseball 
with  a friend,  wished  to  mention  a famous  Chicago  outfielder 
who  has  now  passed  into  obscurity.  But,  though  this 
player’s  name  has  for  years  been  thoroughly  familiar  to 
him,  he  was  surprised  to  find  that  at  the  time  he  was  utterly 
unable  to  recall  it.  He  could  remember  very  clearly  the 
man’s  appearance  and  history,  and  he  also  recalled  that  his 
name  used  to  head  the  Chicago  batting  order,  followed  by 
that  of  Schulte,  which  he  knew  it  resembled  to  the  extent  of 
beginning  with  an  sh  sound.  His  friend,  who  is  not  a 
close  follower  of  the  game,  did  not  remember  the  player  at 
all. 


30  Some  Analyses  in  the  Psychopathology  of  Everyday  Life 

When  the  patient  reported  the  occurrence  to  me  I was 
able  to  tell  him  that  the  name  in  question  was  Sheckard. 
Hardly  had  I pronounced  this  name  when  there  came  un- 
bidden to  the  patient’s  mind  the  word  checkered  and  the 
phrase  a checkered  career.  This  phrase,  which,  as  then 
appeared,  had  in  his  mind  a somewhat  sinister  connotation, 
implying  unsavory  adventure,  dissoluteness,  and  ultimate 
disaster,  accurately  summed  up  a theme  which  at  the  time 
was  most  disturbing  to  the  patient.  Not  only  had  his  past 
contained  a considerable  number  of  somewhat  discreditable 
adventures,  but  at  the  time  he  seemed  unable  to  resist 
certain  temptations  which  bid  fair  to  produce  a repetition 
of  the  past,  and  also  to  involve  him  in  new  difficulties  which 
might  easily  end  in  the  wrecking  of  his  future.  In  short, 
he  had  reason  to  feel  that  his  career,  instead  of  being  one  of 
which  he  could  be  proud,  might  become  one  of  the  checkered 
variety,  according  to  the  most  sinister  acceptation  of  the 
term. 

Instead,  however,  of  facing  these  problems  and  working 
out  a solution,  he  had  chosen  to  put  them  out  of  mind  and, 
as  far  as  possible,  ignore  their  existence.  His  inability  to 
recall  the  name  Sheckard  was  a by-product  of  this  effort. 
The  similarity  in  sound  between  Sheckard  and  checkered  was 
so  close  that  for  him  to  be  conscious  of  the  former  might  also 
involve  his  being  conscious  of  the  latter,  and  thus  bring 
before  his  mind  the  phrase  a checkered  career  and  all  that, 
in  his  life,  it  comprehended. 

It  may  be  added  that  the  likelihood  of  this  theme  being 
brought  to  his  mind  by  the  conversation  with  his  friend  was 
particularly  great,  because  he  had  recently  heard  that  a 
certain  great  ball  player  had  been  forced  to  retire  from  the 
game  by  the  effects  of  venereal  disease.  With  this  player 
he  could  identify  himself,  both  because  he  too  had  once 
possessed  considerable  prominence  in  baseball  and  also  be- 
cause he  had  suffered  a venereal  infection,  which  at  the  time 
was  giving  him  some  anxiety.  This  player  had  once  been 
a member  of  the  Chicago  team,  and  for  that  reason  the 
mention  of  Sheckard  might  easily  have  served  to  recall  him, 
and,  by  means  of  the  existing  identification,  to  bring  into 
consciousness  the  theme  of  “a  checkered  career”  and  its 


H.  W.  Frink 


31 


possible  disastrous  ending.  On  account  of  this  there  was 
required  a defensive  forgetting  that  under  other  circum- 
stances might  not  have  been  necessary. 

There  follow  two  cases  of  omission  in  writing.  The 
second  differs  from  the  foregoing  examples  in  that  it  expresses 
a positive  wish-fulfillment  rather  than  a defense  against 
something  painful. 

IV.  A stenographer,  after  transcribing  from  his  notes 
a long  letter  that  had  been  dictated  to  him,  discovered  that 
he  had  omitted  from  the  transcript  the  following  sentence 
which  was  contained  in  his  notes:  “Divorce  is  out  of  the 
question,  for  the  man  is  a Roman  Catholic.”  There  were 
-no  other  omissions  or  mistakes. 

The  reason  for  this  mistake  was  that  the  man,  who  was 
very  unhappy  in  his  married  life,  was  secretly  pondering  the 
question  of  divorce,  realizing  at  the  same  time  that  it  would 
be  by  no  means  easy  for  him  to  secure  one.  His  omission 
or  forgetting  of  the  sentence  quoted  is  readily  explained  by 
the  fact  that  the  idea  that  “divorce  is  out  of  the  question” 
was  to  him  a painful  one. 

V.  While  serving  as  secretary  of  a certain  society  I 
found,  when  called  upon  to  read  the  minutes  of  the  previous 
meeting,  that  in  writing  them  up  I had  entirely  omitted  the 
usual  formula  “The  President,  Dr.  Blank,  in  the  chair.” 

The  meeting  at  which  I discovered  this  mistake  was 
the  one  at  which  officers  were  nominated  for  the  ensuing 
year.  I had  privately  entertained  hopes  that  at  this  meeting 
I might  be  nominated  for  the  office  of  president.  The 
minutes  of  the  previous  meeting  I had  written  up  from  notes 
just  before  I left  the  house  to  attend  this  one.  My  mistake 
was  an  unconscious  wish-fulfillment,  which  deposed  the 
occupant  of  the  presidential  chair  in  order  that  I might 
have  his  place. 

The  following  example  of  a mistake  in  speaking  is  that 
of  a disturbance  produced  by  the  unwished-for  intrusion  of 
a disagreeable  theme.  It  does  not  correspond  to  a wish- 


32  Some  Analyses  in  the  Psychopathology  of  Everyday  Life 

fulfillment  but  may  be  best  classified  as  an  example  of 
partial  failure  of  defense. 

VI.  At  one  time  I had  a female  patient  who  possessed 
a very  exaggerated  reluctance  to  admitting  that  she  was 
wrong  in  anything  no  matter  how  trivial  the  matter  might 
be.  If  any  one  called  her  attention  to  a mistake,  however 
small,  she  would  either  deny  most  vigorously  that  she  had 
made  it,  or,  if  this  was  entirely  out  of  the  question,  she  would 
seek  in  every  way  to  excuse  herself  for  it. 

This  peculiarity  of  hers  was  a topic  of  conversation 
during  one  of  her  visits  to  me,  and  I had  asked,  “Have  you 
no  idea  of  the  reason  for  your  so  great  unwillingness  ever  to 
admit  yourself  in  the  wrong?” 

“No,  I haven’t,”  she  replied,  pretending  to  think  hard, 
“Is  it  self-ab — self-effacement?” 

As  is  fairly  evident,  the  word  she  had  started  to  use  was 
self-abasement , and  this  she  acknowledged  when  I called 
her  attention  to  the  matter.  Her  substitution  for  it  of  the 
word  self-effacement , one  would  suppose,  must  have  been 
a defense  of  some  sort;  that  is,  the  word  self-abasement 
must  have  bordered  on  or  been  contained  in  some  group  of 
ideas  painful  to  her. 

This  I explained  to  her,  and  she  replied,  “Oh,  I didn’t 
know  that  you  expected  me  to  tell  you  all  about  things  that 
are  past — I stopped  it  two  years  ago.  ” 

Thus  it  is  to  be  seen  that  the  idea  against  which  her 
substitution  defended  was  that  of  “self-abuse.” 

And  so  in  a way  she  had  answered  the  question  I asked 
her.  Her  guilt  complex  about  masturbation  was  one  of  the 
causes  of  her  reluctance  to  admitting  that  she  was  ever 
wrong.  It  was  as  if  as  a defense  against  admitting  herself 
guilty  in  that  regard  (and  in  one  or  two  other  particular 
things)  she  had  resolved  never  to  admit  herself  wrong  in 
anything , very  much  as,  in  warfare,  the  first  line  of  defense 
is  set  up  far  in  advance  of  the  real  point  of  objective  of  the 
attacking  enemy. 

Incidentally,  it  may  be  pointed  out  that  the  patient’s 
question,  “Is  it  self-effacement  (or  abasement)?” — an 
obviously  absurd  response  to  my  question — is  a good  index 


H.  IV.  Frink 


33 


of  her  resistances.  It  is  not  difficult  to  see  that  her  conscious 
thought  was  that  the  probable  reason  for  her  unwillingness 
to  admit  mistakes  was  not  self-abasement,  but,  on  the  con- 
trary, pride.  But  in  her  mood  of  resistance  and  antagonism 
she  gave  the  answer  that  to  her  seemed  just  the  opposite 
of  the  one  expected. 

An  example  of  involuntary  self-revelation  somewhat 
similar  to  this  one  is  that  of  a patient  who  said  “sins  of 
emission”  when  he  had  meant  to  say  “sins  of  omission.” 


THE  MENTAL  IMAGERY  OF  STUTTERERS:  AN 
EXAMINATION  OF  CERTAIN  CURRENT 
THEORIES 


BY  JOHN  M.  FLETCHER 

Professor  of  Psychology , Newcomb  College  of  Tulane  Univer- 
sity, New  Orleans , La. 

SINCE  the  middle  of  the  eighteenth  century  authorities 
in  constantly  increasing  numbers  have  claimed  that 
stuttering  is  essentially  a mental  abnormality.  It 
is  rather  interesting  to  note,  as  one  does  occasionally, 
a belated  student  of  this  subject  rising  to  announce  that  he 
has  ‘discovered’  or  has  ‘conclusively  shown’  wrhat  other  stu- 
dents have  ‘discovered’  and  ‘shown’  many  years  ago.  To 
feel  that  we  have  at  least  got  far  enough  to  reach  an  agree- 
ment as  to  the  general  character  of  this  affliction  is  encourag- 
ing, for  we  have  passed  the  stutterer  by  for  centuries  with 
a feeling  of  ignorant  fatalism  as  hopeless  as  that  which  once 
greeted  many  other  human  ailments  that  now  yield  to 
treatment.  But  when  one  studies  the  wild  guesses  and 
hasty  conclusions  as  to  just  what  constitutes  the  essential 
nature  of  the  stutterer’s  mental  abnormality  one  feels  like 
warning  him  against  expecting  an  early  day  of  deliverance. 

There  are  at  present  two  widely  divergent  theories  on 
this  point  of  the  general  character  of  the  defect.  One, 
adopting  the  Freudian  hypothesis,  holds  that  stuttering  is 
the  result  of  repressed  emotional  complexes  of  a sexual  kind 
that  date  back  to  childhood.  The  writer  is  at  present 
gathering  data  regarding  one  of  the  fundamental  assump- 
tions of  this  theory  and  hopes  to  submit  conclusions  at  a 
later  date.  The  second  prominently  mentioned  theory, 
and  the  one  which  I beg  to  notice  in  the  present  paper, 
holds  that  stuttering  is,  (as  one  author  actually  asserts) 
or  rather,  is  due  to,  an  abnormality  of  mental  imagery. 
The  essential  features  of  this  theory  were  first  stated,  as 


34 


John  M.  Fletcher 


35 


far  as  I know,  by  T.  Hoepfner*.  Two  varieties  of  the  theory 
have  appeared  in  the  American  literature.  q,One  is  the  thesis 
of  what  Bluemel  calls  a ‘monograph,’  but  which  I only 
know  as  a chapter  in  a two  volume  book.|  This  thesis  is, 
to  quote,  (V.  I,  p.  187)  that,  “The  stammerer’s  difficulty 
is  transient  auditory  amnesia.”  He  says,  however,  that 
the  stutterer  is  of  a fixed  imagery  type,  being  an  “audito- 
moteur,  ” but  in  the  act  of  attempting  to  speak  he  loses  the 
auditory  imagery,  and  cannot  reproduce  mentally  the 
“vowel-color,”  but  relies  wholly  on  kinaesthetic  images. 

Another  type  of  this  same  theory  is  that  which  has  been 
proposed  by  Dr.  Swift, | although  Dr.  Swift  speaks  of  his  as 
a “new  finding.”  His  theory  is  stated  as  follows  (Ibid, 
p.  235.)  “Psychoanalysis  reveals  stuttering  as  some  vague 
trouble  in  the  personality.  Psychological  analysis  shows 
stuttering  is  (!)  an  absent  or  weak  visualization  at  the  time 
of  speech.  This  new  concept  of  stuttering  as  faulty  visual- 
ization may  be  called  Visual  Central  Asthenia.  This  lack 
or  weakness  in  visualization  accounts  for  all  the  numerous 
phenomena  of  stuttering  in  severe,  medium,  or  mild  cases.” 

The  method  by  which  Dr.  Swift  secured  the  data  on 
which  he  bases  his  conclusions  may  be  described  as  follows: 
He  began  his  preliminary  tests  by  asking  his  subject  to 
answer  a question,  and  then  to  repeat  a sentence  after  him. 
The  question  and  sentence  were  (1)  “Where  do  you  live?” 
and  (2)  “The  dog  ran  across  the  street.”  The  subject  was 
then  requested  to  report  “whether  there  was  any  picture  in 
the  content  of  consciousness  and  how  long  it  lasted;  and 
whether  that  was  detailed,  intense  or  weak.”  He  sum- 
marized the  results  by  saying  that  of  twenty  stutterers  ten 
had  no  visual  imagery;  one  imaged  faintly;  two  visualized 
clearly  but  the  “picture  vanished  on  speaking;”  seven,  who 
had  been  under  treatment,  visualized  their  homes  clearly. 
In  repeating  the  sentence,  ten  had  no  visualization  at  all; 
one  visualized  faintly;  “four  visualized  well  but  the  picture 

*Hoepfner,  T. : Stottern  als  assoziative  Aphasie.  Zeits.  f.  Pathopsychol.,  I., 
1912.  449-552. 

tBluemel,  C.  S.:  Stammering  and  Cognate  Defects  of  Speech,  2 vols.  New 
York,  19x3. 

fSwift,  Walter  B.:  A Psychological  Analysis  of  Stuttering.  Jour.  Abn. 
Psychol.  X,  1915.  225-235. 


36 


The  Mental  Imagery  of  Stutterers 


vanished  on  speaking;”  five  others,  of  whom  four  had 
received  treatment,  “reported  visualization.” 

After  testing  his  stutterers  by  this  method  he  examines 
normal  persons  in  the  same  manner,  and  concludes  that 
“almost  without  exception”  they  visualize  clearly  before 
speaking.  These  preliminary  tests,  he  thinks,  “warranted 
the  tentative  conclusion  that  stutterers  have  a loss  or 
diminished  power  of  visualization.” 

Thus  encouraged  he  undertook  what  he  calls  a “further 
and  more  exhaustive  investigation,”  by  which  he  desired 
to  establish  certain  points  regarding  the  extent  of  this  weak- 
ness in  stutterers  as  compared  with  normal  persons,  and  also 
the  variations  of  it  with  the  variations  in  the  severity  of 
stuttering.  The  language  used  in  stating  certain  of  the 
objects  of  this  final  series  of  tests  is  in  some  cases  out  of 
the  ordinary,  to  say  the  least.  For  instance,  “Is  it  (i.  e. 
visualization)  the  same  for  past,  present  and  future 
memories?”,  also  “Is  visualization  equally  at  fault  in  all 
sensory  areas  of  the  cortex?”  In  attaining  the  objects  of  the 
tests,  as  thus  stated,  he  employed  eight  sets  of  questions  or 
sentences,  each  set  containing  three.  “This  long  series  of 
questions,”  he  says,  “with  careful  introspection  tests  upon 
the  content  of  consciousness  constituted  then  my  main 
research  in  the  field  of  stuttering.” 

On  nineteen  subjects  some  four  hundred  tests  wrere 
made,  and  from  over  fourteen  hundred  answers,  he  has 
drawn  in  the  main  three  conclusions,  namely,  (l)“  When 
visualization  is  present  stuttering  is  absent;  when  visualiza- 
tion is  absent  stuttering  is  present;”  (2)  that  the  severity 
of  stuttering  varies  - with  the  clearness  of  visualization, 
as  shown  in  the  progress  of  treatment;  and  (3)  finally  he  says, 
(though  who  knows  what  he  means?)  that  “visualization  is 
slightly  more  frequent  for  past  and  future”  than  for  present 
memories. 

Before  examining  Dr.  Swift’s  conclusions  it  is  well  to 
call  attention  to  what  seem  to  me  to  be  very  serious  flaws 
in  his  method.  In  his  preliminary  tests,  for  example,  after 
submitting  the  question  and  the  sentence  to  the  subject 
he  asks  him  to  state  “whether  there  was  any  picture  in  the 
content  of  consciousness,  ” etc.  Now,  every  teacher  of 


John  M.  Fletcher 


37 


psychology  knows  that  it  is  often  difficult  to  disabuse  the 
minds  of  students  of  the  impression  that  image  always 
means  visual  image.  Now,  if  in  questioning  his  patients, 
who,  I assume,  had  no  psychological  training,  he  used  the 
term  ‘picture,’  as  he  reports,  one  may  be  reasonably  sure 
that  the  subjects  understood  him  to  mean  visual  images 
only  and  answered  him  accordingly.  Untrained  subjects 
are  bad  enough  at  best  in  this  matter  of  introspection,  as  I 
know  from  several  years  of  experience  in  studying  them,  but 
when  the  experimenter  himself  actually  contributes  to  the 
confusion  the  situation  becomes  worse.  That  Dr.  Swift 
has  done  this  can,  I believe,  be  shown  in  several  ways.  In 
the  first  place  in  describing  his  methods  he  seems  in  certain 
instances  to  use  the  term  ‘visualization’  as  synonymous  with 
‘image’  as  ordinarily  used  in  psychology.  For  instance, 
as  already  noted,  in  stating  the  objects  of  the  final  series  of 
tests  he  asks  “Is  visualization  equally  at  fault  in  all  sensory 
areas  of  the  cortex?”  Now,  as  there  can  be  no  visualization 
in  any  but  the  visual  areas  of  the  cortex  he  seems  to  be  using 
the  term  here  to  mean  concrete  imagery  in  general.  He  not 
only  mentions  that  “visualization  is  absent  in  other  areas  as 
well,”  but  he  even  speaks  about  “the  holding  of  an  emotion 
of  pleasure  or  pain  and  of  other  dominating  mental  attitudes 
that  are  sometimes  visualized.  ” To  talk  about  visualizing 
an  emotion  in  the  sense  in  which  psychologists  speak  of 
visualizing  is  of  course  the  sheerest  nonsense.  Only  an 
ultra  modern  artist  would  attempt  such  a task.  And  yet, 
in  spite  of  this  there  is  good  reason  to  conclude  that,  when 
he  uses  the  term  ‘visualization,’  a more  restricted  meaning 
must  be  given  it.  For  example,  he  says  (p.  234)  “Our  data 
above  has  shown  us  that  the  location  of  the  trouble  is  visual; 
that  is,  it  is  situated  about  a centre  of  sensory  registration 
that  deposits  data  from  the  eye;  this  must  naturally  then  be 
located  somewhere  in  or  near  the  cuneus.”  There  can  be 
no  mistake  about  the  meaning  of  this  language.  Hence, 
one  is  naturally  inclined  to  ask,  which  one  of  these  two  very 
different  meanings  of  ‘visualization’  did  the  stutterer  choose 
when  questioned  by  Dr.  Swift? 

Other  faults  of  method  equally  calculated  to  lead  to 
confusion  could  be  pointed  out  in  the  lists  of  questions  pre- 


38 


The  Mental  Imagery  of  Stutterers 


sumably  intended  to  cover  all  the  general  classes  of  images. 
For  instance,  to  call  attention  to  one  only,  the  first  list  he 
calls  ‘speech.’  Now  just  what  he  means  by  ‘speech’ 
imagery  over  and  above  the  motor,  auditory,  and  visual 
imagery,  which  he  includes  elsewhere  in  his  list,  he  does  not 
indicate. 

The  amount  of  careful  work  that  has  been  done  by 
psychologists  in  the  study  of  imagery  types  and  of  the  general 
functions  of  imagery  in  mental  processes  gets  not  even  a 
passing  notice  from  Dr.  Swift.  One  hesitates  to  think  that 
an  investigator  would  announce  a “new  psychological 
finding”  in  a well-known  psychological  journal,  as  he  has 
done*,  without  some  acquaintance  with  what  has  already 
been  accomplished  in  that  line.  The  only  alternative  con- 
clusion is  that  he  knows  the  work  in  these  lines  but  considers 
that  it  does  not  merit  mention  much  less  adoption.  It  is 
only  fair  to  psychology  to  say  that  it  will  insist  on  passing 
judgment  on  what  is  offered  to  it  as  a discovery.  This  is 
surely  no  less  than  the  medical  fraternity,,  of  which  I am  sure 
Dr.  Swift  is  an  honored  member,  would  insist  upon,  indeed, 
has  always  insisted  upon,  in  similar  cases. 

Aside  from  the  question  of  the  technic  of  the  study  of 
mental  imagery  there  is  involved  in  Dr.  Swift’s  conclusions 
much  that  bears  upon  the  general  question,  quite  old  in 
psychology,  of  the  relation  of  imagery  to  movement.  He 
seems  to  have  cut  with  one  blow  the  entire  knot  of  this 
problem.  Indeed,  he  has  done  more.  The  ideo-motor 
actionists  assumed  that  the  image  in  consciousness  tended 
to  inaugurate  the  movement  that  was  “similar”  to  it  or 
that  it  represented.  The  well  known  statement  of  James  is 
this:f  “We  may  then  lay  it  down  for  certain  that  every 
representation  of  a movement  awakens  in  some  degree  the 
actual  movement  which  is  its  object ” (Italics  mine).  The 
imaginal  representation  by  the  stutterer  of  a dog  running 
across  the  street  obviously  neither  “represents”  nor  is  in  any 
way  “similar”  to  the  motor  processes  involved  in  uttering 

♦Swift  Walter  B.:  Some  Developmental  Psychology  in  Lower  Animals  and 

in  Man  and  Its  Contribution  to  Certain  Theories  of  Adult  Mental  Tests.  Amer. 
Jour.  Psychol.  XXVII,  1916,  71-86. 

tjames,  William:  Psychology,  Vol.  II,  p.  526. 


John  M.  Fletcher 


39 


the  sentence  describing  this  event.  Kinaesthetic  images 
have  at  various  times  been  considered  to  be  the  necessary 
mental  antecedent  of  voluntary  action.  Such  phenomena 
as  the  loss  of  motor  control  through  the  destruction  of  the 
sensory  tracts  in  tabes  dorsalis,  as  well  as  the  findings  in  the 
studies  of  the  acquisition  of  habit  and  voluntary  control  in 
normal  subjects,  have  led  to  this  conclusion.  Recent  in- 
vestigation, however,  has  called  in  question  the  assumption 
of  an  inherent,  necessary,  and  permanent  connection  between 
image  and  movement.  Passing  by  the  well-known  attack 
by  Thorndike*  on  the  theory  of  ideo-motor  actionism,  we 
may  take  a more  conservative  statement  by  Pillsbury  who 
saysf  “The  more  the  antecedents  of  action  are  observed 

the  more  evident  it  becomes  that  the  directing 

idea  may  be  any  sort  of  image  whatever.  In  many  cases, 
the  imagery  is  very  indefinite,  seems  to  be  very  largely 
lacking.  ” 

Now,  if  psychology  is  finding  itself  compelled  to  call  in 
question  the  existence  of  a fixed  and  necessary  relation  be- 
tween even  kinaesthetic  images  and  the  movements  that 
they  represent,  what  is  to  be  said  of  a theory  which  assumes 
the  existence  of  such  a relation  between  visual  images  of  the 
objects  thought  of  and  the  movements  of  the  speech  organs 
carried  out  in  speaking,  that  is,  in  saying  anything  whatso- 
ever, about  these  objects?  Dr.  Swift’s  theory  must  neces- 
sarily assume  that  there  is  one  path  by  which  the  neural 
processes  involved  in  speech  normally  travel,  and  this  is 
via  the  visual  centers,  so  that  when  it  becomes  obstructed, 
speech  is  blocked,  whereas,  when  it  is  open  speech  is  free. 
He  does  not  make  clear  whether  he  considers  this  path  to  be 
due  to  heredity  or  to  individual  experience.  The  same 
thing  must  be  said  of  Bluemel,  for  although  he  saysj,  “The 
stammerer  is  an  audito-moteur,  ” which  one  would  naturally 
understand  as  meaning  a permanent  type,  in  the  same 
connection  and  elsewhere  he  declares  that  the  stutterer’s 
imagery  disturbances  are  transient,  i.  e .,  they  become 
manifest  only  in  the  attempt  to  speak.  There  is  undoubted- 
ly a closer  functional  connection  between  auditory  images. 

*Thorndike,  E.  L. : Ideo-Motor  Action.  Psychol.  Rev.,  March  1913. 

fPillsbury,  W.  B.:  The  Essentials  of  Psychology,  pp.  298-299. 

ILoc.  cit.  V.  II,  p.  187. 


4o 


The  Mental  Imagery  of  Stutterers 


and  vocal  sounds  than  there  is  between  visual  images  and 
vocal  sounds.  The  congenitally  deaf,  for  example,  are 
liable  to  be  dumb;  the  congenitally  blind  are  not.  The 
congenitally  deaf  even  after  being  taught  to  speak,  usually 
show  marked  peculiarities  of  speech.  Bluemel,  strange  to 
say,  does  not  employ  this  argument  in  this  way,  however, 
but  says*  that  his  claim  that  stuttering  is  an  auditory  dis- 
turbance is  borne  out  by  the  fact  that  “stammering  seems  to 
be  entirely  absent  among  the  congenitally  deaf  that  have 
been  taught  to  speak!” 

If  the  neural  speech  path  is  the  result  of  individual 
experience,  if  one  has  learned  to  rely  upon  a certain  kind  of 
imaginal  cue  for  the  inauguration  of  speech  movements,  one 
might  conclude  a priori  that  speech  would  become  affected 
if  these  cues  were  disturbed  suddenly.  There  are  cases, 
however,  of  both  gradual  and  sudden  changes  in  imagery 
habits  without  any  resultant  disturbances  of  speech.  Gal- 
ton  in  his  well  known  study  of  men  of  science  says  of  them 
that  “their  faculty  of  seeing  pictures  (cf.  Swift’s  terminol- 
ogy) ...  if  ever  possessed  by  man  of  highly  general- 
ized and  abstract  thought,  is  very  apt  to  be  lost.  ” “ Speech 

movements,”  says  Hoepfnerf  “are  the  first  to  lose  their 
concrete  imaginal  character  and  become  abstract.”  As 
speech  matures  the  mental  antecedents  become  more  and 
more  general  and  vague.  The  attention  also  tends  more  and 
more  to  shift  from  the  original  processes  of  speech,  including 
the  imaginal  antecedents,  to  the  meaning  of  the  thought  to 
be  expressed.  Moreover,  not  even  where  such  changes  have 
taken  place  rapidly  are  speech  disturbances  found  to  follow. 
For  example,  Charcot  speaks  of  a person  who  “possessed  at 
one  time  a great  faculty  of  picturing”  to  himself  the  persons 
and  things  about  which  he  was  thinking.  But,  as  he  relates, 
“all  of  a sudden  this  internal  vision  absolutely  disappeared,  ’ 
so  that  he  could  no  longer  image  the  faces  even  of  his  wife 
and  children.  I do  not  know  of  any  evidence  that  this 
person  became  a stutterer,  which,  if  Dr.  Swift’s  theory  be 
correct,  should  have  been  the  result. 

Reverting  to  Dr.  Swift’s  main  thesis,  we  note  that  it  is 

*Ibid.  p.  234. 

fLoc.  cit.  o.  26S. 


John  M.  Fletcher 


41 


stated  in  the  following  terms : “ When  visualization  is  present 
stuttering  is  absent;  when  visualization  is  absent  stuttering 
is  present.”  Thus  stated  there  is  not  only  a seeming  con- 
formity to  Mill’s  logical  canon  of  Agreement  and  Difference, 
but,  by  asserting  further  that  stuttering  varies  pari  passu 
with  visualization,  he  adds  a conformity  to  the  canon  of 
Concomitant  Variation  as  a sort  of  logical  lagniappe.  But 
a cardinal  principle  in  the  use  of  these  canons  is  to  make 
sure  that  we  have  taken  account  of  all  the  variant  factors 
involved.  This  I think  it  is  quite  certain  Dr.  Swift  has 
failed  to  do.  Chief  among  the  variant  factors  which  he  has 
ignored  may  be  mentioned  the  shift  of  attention  with  the 
resultant  changes  in  attitude  and  the  consequent  release  of 
inhibitions.  It  has  long  been  observed  that  attention  plays 
an  important  part  in  stuttering.  The  ordinary  convulsive 
tic,  for  example,  may  be  controlled  when  attention  is  volun- 
tarily concentrated  upon  it,  whereas  the  convulsive  move- 
ments of  stuttering  are  relieved  rather  when  the  attention 
is  distracted*.  .The  writer  has  attempted  to  state  this 
as  follows:!  “Placing  .corks  or  wedges  between  the  teeth, 
shrugging  the  shoulders,  tapping  with  the  feet,  pinching 
with  the  fingers,  whistling  or  counting  before  speaking,  and 
numerous  similar  therapeutic  expedients,  all  of  which  have 
been  known  to  be  effective  in  certain  cases,  seem  to  owe  their 
efficacy  to  the  fact  that  they  distract  the  attention  of  the 
stutterer  from  his  difficulty,  and  that,  in  consequence,  they 
afford  him  a relief  from  the  morbid  inhibitions  by  which  his 
speech  is  hindered.  Stuttering  has  been  frequently  al- 
leviated by  the  act  of  writing  during  speech.  Many 
stutterers  can  speak  perfectly  while  sewing,  embroidering, 
or  playing  a piano.  Others  resort  to  blowing  the  nose,  to 
scratching  the  head  or  to  stroking  the  mustache  before 
attempting  to  speak.” 

For  the  stutterer  to  visualize  the  objects  he  is  talking 
about  will  afford  the  same  kind  of  distraction  from  his 
habitual  states  of  mind  in  speech  as  do  the  expedients  just 

*Bonnet,  Louis  A.  L.:  Etude  critique  sur  la  parente  morbide  du  begaiement 
avec  les  tics  et  !es  crampes  fonctionelles.  Bordeaux  1906.  168  pp. 

fFletcher,  John  Madison:  An  Experimental  Study  of  Stuttering.  Amer. 

Jour.  Psychol.  XXV,  1914,  p.  239. 


42 


The  Mental  Imagery  of  Stutterers 


mentioned,  and  for  this  reason  alone  it  may  be  expected  to 
have  the  same  effects  on  his  speech.  When  a stutterer 
hears  a sentence  which  he  has  been  asked  to  repeat,  the  thing 
naturally  uppermost  in  his  mind  is  not  the  meaning  of  it 
or  the  visual  qualities  of  the  objects  described  in  it,  but  his 
own  chances  of  uttering  it  without  stuttering.  He  is  as 
capable  as  others  of  appreciating  meaning,  and,  as  I have 
repeatedly  found  by  experiment,  of  visualizing,  but  the 
pressing  and  painful  need  of  the  moment  is  to  avoid  stutter- 
ing if  possible.  Many  people,  I fear,  fail  to  realize  that 
stuttering  is  to  the  stutterer  a very  unpleasant  experience. 
The  anticipation  of  painful  or  unpleasant  experiences  is  the 
natural  source  of  dread  and  fear.  That  the  stutterer  is  in  a 
state  of  dread  or  fear  while  anticipating  the  necessity  of 
speaking,  I have  demonstrated,  at  least  to  my  own  satis- 
faction, both  by  introspective  and  objective  evidence.  As 
a sample  of  the  latter  kind  of  evidence  I have  found*  in  a 
certain  group  of  stutterers  that  the  average  pulse-rate  after 
being  told  that  they  would  be  asked  to  speak,  but  before 
speaking,  was  90.2  with  a maximum  of  120.  To  ignore 
this  dread  or  fear,  which  is  absent  in  the  normal  speaker  and 
always  present  in  the  stutterer,  and  to  attempt  an  explana- 
tion solely  on  the  basis  of  the  imaginal  or  ideational  protesses 
involved  in  speech  is,  to  my  mind,  the  fatal  error  into  which 
both  Bluemel  and  Swift  have  fallen.  They  hold  that  the 
stutterer  stutters  because  he  loses  his  mental  imagery, 
whereas  in  fact  he  loses  his  mental  imagery  because  of 
stuttering,  or  the  morbid  mental  states  that  have  their 
origin  in  the  painful  experiences  of  stuttering.  It  is  the 
study  of  causes  not  of  symptoms  that  will  open  the  way  to 
progress  in  the  study  of  this  problem  as  it  did  in  the  case  of 
the  study  of  hysteria. 

The  chief  purpose  of  this  contribution  is  to  offer  criti- 
cisms against  certain  current  theories  concerning  the  essen- 
tial pathology  of  stuttering.  The  theories  criticised  seem 
on  their  face  to  be  so  palpably  wrong  that  a lengthy  investi- 
gation into  their  merits  seems  unnecessary.  However,  by 
methods  in  common  use  in  psychology,  I have  made  a study, 
since  the  appearance  of  the  theories  mentioned,  of  three 
cases,  and  have  found  in  them  the  following  general  condi- 
tions of  imagery  to  exist: 

*Ibid.  p.  226. 


John  M.  Fletcher 


43 


1.  There  were  no  permanent  peculiarities  of  imagery 
that  would  in  any  way  distinguish  them  from  normal 
persons. 

2.  No  pure  imagery  type  was  found,  each  of  them 
employed  different  kinds  of  imagery  in  thought  processes 
with  a possible  preponderance  of  visualization. 

3.  When  asked  to  react  by  speaking  the  stutterer  has 
a tendency,  in  proportion  roughly  to  the  severity  of  his 
difficulty,  to  lose  not  only  visual  but  all  other  kinds  of 
imagery  immediately  before  speaking.  These  images  tend 
to  give,  way,  for  the  most  part,  to  kinaesthetic  sensations 
localized  especially  in  the  throat  and  in  the  organs  of  articula- 
tion. When  asked  to  react  by  writing,  detailed,  and  in 
certain  instances  vivid,  imagery  was  reported. 


THE  STUTTERING  BOY 


BY  KNIGHT  DUNLAP 

Professor  of  Experimental  Psychology  in  the  Johns  Hopkins 

U niversity 

HAVE  you  ever  seen  a stuttering  girl?  A girl,  that 
is,  who  chronically  stutters?  If  so,  you  have 
observed  a phenomenon  which  is  rare,  although 
stuttering  boys  are  common  enough.  However 
badly  coordinated  or  hysterical  may  be  the  actions  of  girls 
and  young  women,  the  disturbances  seldom  take  the  form 
of  the  annoying  repetition  of  the  same  syllable  which  is 
properly  called  stuttering.  That  other  form  of  stammering 
in  which  there  is  a deadlocking  of  the  vocal  apparatus  so 
that  no  sound  is  uttered  for  a painfully  long  period,  with 
practically  no  other  abnormal  behavior,  is  also  relatively 
infrequent  in  females.  Stuttering,  and  to  a less  extent 
stammering  in  general,  is  peculiarly  a masculine  derange- 
ment. 

It  is  obvious  that  there  must  be  some  connection 
between  this  sex-limitation  of  stuttering,  and  the  cause  or 
causes  of  the  trouble.  The  source  of  stuttering  must  be 
sought  in  some  peculiarity  of  the  language  function  of  the 
male  which  is  not  found  in  the  language  function  of  the 
female,  and  not,  as  is  popularly  supposed,  in  mere  shock, 
fright  or  ‘nervousness.’  I have  heard  detailed  stories  con- 
cerning various  stutterers,  dating  the  beginnings  of  their 
speech  difficulty  from  a severe  fright  in  one  case,  from  the 
shock  of  an  accident  in  another  case,  from  an  attack  of 
typhoid  which  left  a weakened  system  in  another,  and  soon. 
Even  if  we  were  not  forced  to  discount  these  histories  heavily, 
we  would  be  obliged  to  conclude  that  they  are  only  contri- 
buting causes;  agencies  which  by  weakening  the  resistance 
gave  the  real  cause  a chance  to  get  in  its  deadly  work. 

The  theory  of  stuttering  which  suggests  itself  most 


44 


Knight  Dunlap 


45 


readily  is  based  on  the  supposition  that  in  the  animal 
kingdom  generally,  the  voice  of  the  male  is  more  definitely 
a sex-function  than  is  the  voice  of  the  female.  The  voice  is 
one  means  of  wooing;  and  we  might  expect  that  in  the  sex- 
excitability  of  the  adolescent  period  this  function,  so  in- 
timately associated  with  the  primary  sex-functions,  would 
be  especially  liable  to  derangement.  This  may  indeed  be 
so;  although  there  is  little  evidence  that  in  the  human  animal 
the  male’s  voice  is  more  sex-expressive  than  is  the  female’s, 
or  that  the  adolescent  boy  is  more  excitable  sexually  than  is 
the  girl.  In  any  case,  this  theory  does  not  explain  why  the 
speech  derangement  takes  the  general  form  of  stammering 
or  the  specific  form  of  stuttering,  and  hence  the  causes  it 
proposes  are  at  the  most  but  contributing  or  predisposing 
influences. 

The  actual  determining  cause  of  stammering  for  a large 
proportion  of  cases  is  clearly  indicated  by  the  data  obtainable 
from  the  cases  themselves.  Two  facts  stand  out  from  this 
data:  first,  that  the  stammering  dates  (where  the  dating 

can  be  definitely  made),  from  the  time  when  the  boy  first 
went  to  school,  or  began  first  to  associate  with  a number  of 
other  boys;  and  second,  that  in  many  cases  (not  in  all),  the 
stammerer  has  especial  difficulty  with  words  beginning  with 
one  of  a small  group  of  sounds— the  sounds  with  which 
certain  obscene  words  much  favored  by  small  boys  also 
begin.  Bearing  these  two  facts  in  mind,  it  is  usually  possible 
to  find  that  at  the  time  when  the  stammering  commenced 
to  develop,  the  boy  became  familiar  with  a certain  list  of 
terms  which  he  employed  with  satisfaction  among  his 
juvenile  friends,  but  which  it  would  never,  never  do  to  let 
his  mother,  father  or  sisters  hear.  These  terms  are  usually 
obscene,  but  may  be  in  part  profane  expressions,  or  merely 
words  like  ‘damn’  or  ‘hell.’ 

The  boy  who  has  a rugged  constitution  may  keep  his 
two  linguistic  personalities  distinct  and  apparently  suffer 
no  harm.  The  boy  who  has  no  great  scruple  (or  fear)  about 
letting  out  his  gutter-vocabulary,  occasionally  at  least,  in 
the  hearing  of  his  family,  never,  so  far  as  my  observations 
go,  becomes  a stammerer.  But  the  boy  who  is  ‘carefully 
brought  up,’  if  he  is  handicapped  by  a weak  constitution,  or 
predisposed  by  hereditary  tendency  to  erratic  muscular 
activity  (such  as  may  be  expressed  by  continual  twitches  of 


46 


The  Stuttering  Boy 


the  face,  ‘nervous’  movements  of  the  hands  or  feet,  etc.) 
is  very  apt  to  become  a stutterer,  or  a stammerer  of  the 
deadlock  type. 

The  enunciation  of  a word  is  a complicated  process, 
requiring  the  cooperation  of  a large  number  of  muscles  in  a 
very  intricate  combination;  which  is  bound  together  by 
what  we  call  in  psychological  language,  association.  Two 
words  which  begin  with  the  same  sound — as  for  example, 
slice p and  jAingle,  have  the  same  initial  group  of  movements 
associated  with  different  succeeding  movements  in  the  two 
cases.  Hence  there  is  always  a possibility  that  the  initial 
sound  which  ought  in  a given  case  to  be  followed  by  the 
remainder  of  the  one  word,  may,  through  the  going  astray 
of  the  association  be  followed  by  the  remainder  of  the 
wrong  word;  a type  of  ‘slip  of  the  tongue’  which  occurs 
occasionally  to  every  one.  The  boy  in  constant  fear  lest 
one  of  his  obscene  terms  may  slip  out  in  the  wrong  company, 
and  having  experienced  this  dangerous  tendency  of  words 
to  go  astray,  soon  comes  to  hesitate  over  every  word  which 
begins  in  the  same  way  as  do  these  dangerous  words;  and  as 
the  hesitation  becomes  a more  and  more  fixed  and  noticeable 
habit,  it  extends  to  other  types  of  words  also. 

This  danger  of  a slip  would  not  be  present,  of  course,  if 
the  forbidden  words  were  not  associated,  as  wholes,  with  the 
other  words  in  the  boy’s  habitual  forms  of  speech.  The  root 
of  the  whole  trouble  is  that  the  boy  has  formed  the  habit 
of  using  these  terms,  not  merely  in  discussing  matters  of 
sex  (which  of  course  he  would  not  ordinarily  discuss  with  his 
family)  but  also  in  talking  of  more  commonplace  topics. 

The  peculiar  feature  of  stuttering:  the  repetition  of  the 
syllable  many  times,  is  a result  of  the  usual  method  of 
checking  the  utterance  of  a word;  the  nervous  discharge 
which  should  go  to  the  forming  of  the  remainder  of  the  word 
must  go  somewhere,  and  the  easiest  disposal,  in  the  beginning 
of  the  trouble,  is  to  let  it  discharge  into  the  same  act  which 
has  already  occurred,  namely,  the  production  of  the  initial 
sound  of  the  word.  In  later  stages  of  the  disease,  the 
nervous  energy  may  be  discharged  to  the  muscles  of  the 
face  in  such  a way  as  to  give  the  tetanic  contractions  of  the 
nonstuttering  stammerer.  Usually,  however,  the  stuttering 


Knight  Dunlap 


47 


rapidly  becomes  a permanent  habit,  although  complicated 
by  the  other  type  of  stammering. 

Simplistic  as  this  explanation  sounds,  a very  large 
proportion  of  the  cases  of  stammering  are  directly  traceable 
to  it.  In  most  cases  the  boy’s  parents  have  not  merely 
established  conditions  excellent  for  the  habit-formation, 
but  have  more  directly  contributed  by  administering  drastic 
punishment  (such  as  washing  out  the  mouth  with  soap), 
or  still  more  deadly  moral  horror,  when  a telltale  slip  has 
occurred. 

Other  causes  of  stammering,  of  course,  occur:  but  they 
are  generically  like  the  more  frequent  causes  just  described. 
The  fear  of  giving  incriminating  information  of  some  sort 
other  than  that  of  mere  vocabulary;  an  undue  sensitiveness 
or  worry  about  certain  topics  not  discussed  in  mixed  com- 
pany; or  similar  mental  conflicts;  are  at  the  bottom  of 
certain  cases,  which  usually  are  not  of  the  typical  stuttering 

type- 

The  reason  girls  do  not  stutter  is  fairly  evident.  They 
are  not  subjected  to  the  same  conditions  as  are  boys  and 
do  not  develop  the  same  fear  of  revealing  a tabu  vocabulary, 
although  they  may  have  incriminating  matter  to  conceal, 
and  may  develop  accordingly  a hesitating  type  of  stammer- 
ing. Small  girls  undoubtedly  do  discuss  with  their  school- 
mates matters  of  which  their  purblind  guardians  presume 
them  to  be  quite  ignorant;  but  they  do  not  embody  the 
vulgar  terms  of  these  topics  in  their  conversation  about 
other  matters,  as  boys  do,  and  hence  they  have  little  fear 
of  words  popping  out  of  their  mouths  at  inauspicious  times. 

You  have  probably  heard  angry  girls  of  tender  age  reel 
off  strings  of  smutty  words  worthy  of  the  best  efforts  of  any 
boy;  but  these  girls  are  practically  always  from  homes  in 
which  an  occasional  (or  frequent)  outburst  of  such  diction 
would  have  no  very  disastrous  consequences.  ‘Proper’  little 
girls  do  not  talk  that  way  among  themselves — ‘proper’ 
little  boys  do,  and  it  is  the  ‘proper’  little  boys  who  become 
stutterers.  There  are,  however,  some  stuttering  girls,  and 
they  have  undoubtedly  been  subjected  to  precisely  the  same 
social  conditions  which  produce  stuttering  boys. 

What  has  been  said  above  applies  to  the  cases  of  chronic 


48 


The  Stuttering  Boy 


stammering.  Everyone  stammers  and  stutters — more  or 
less,  just  as  everyone  shows  from  time  to  time  a variety  of 
inaccuracies  of  movements  of  other  types.  Imitation 
plays  a definite  role  in  some  cases.  Occasionally  a family  is 
found  in  which  nearly  all  the  members  stutter;  inheriting 
in  common  a ‘nervous’  disposition,  the  form  of  expression 
it  takes  in  one  member  may  determine  the  form  in  the 
others.  The  imitative  factor  is  often  shown  in  a ludicrous 
way  when  a person  who  normally  does  not  stutter  is  talking 
to  a chronic  stutterer.  In  such  cases,  especially  when  there 
is  emotional  excitement,  it  may  be  difficult  for  the  auditor 
to  determine  which  of  the  two  is  the  worst  stutterer. 

The  cure  of  stuttering  is  a difficult  matter.  In  most 
cases  the  original  cause  has  ceased  to  operate,  and  the 
stuttering  has  become  merely  a fixed  and  well-nigh  un- 
breakable habit  before  expert  assistance  is  sought.  But  the 
prevention,  which  is  a more  important  matter,  would  be 
relatively  simple,  if  it  did  not  require  a certain  degree  of 
intelligence  on  the  part  of  the  parents;  a requirement  which 
few  of  us  parents  meet  in  regard  to  our  own  children.  The 
essential  thing  is  the  avoidance  of  the  fear-stimulus.  If  your 
small  boy,  who  probably  can  use  some  lurid  language  among 
the  fellows,  knows  that  (as  one  small  stutterer  expressed  it  to 
me),  you  would  “have  a fit”  if  you  found  him  out,  you  are 
taking  an  unjustifiable  risk,  however  small,  of  making  a 
stutterer  of  him,  and  a great  deal  larger  risk,  of  course,  of 
making  him  immoral  in  some  other  way.  There  are  far 
safer  and  more  effective  ways  of  discouraging  the  taste  for 
bad  language  than  by  taking  the  I-would-be-shocked  or  the 
it-would-break-my-heart  attitude.  I would  give  this  ad- 
vice to  any  father;  if  your  small  boy  commences  to  stutter, 
find  out  what  obscene  and  otherwise  objectionable  terms  the 
boy  is  apt  to  be  using,  and  then  make  an  opportunity  to  talk 
to  him  about  these  terms,  telling  him  (if  you  can  truly) 
that  you  did  use  these  or  equivalent  words  yourself,  and 
have  stopped  it.  At  any  rate,  make  it  plain  to  him  in  one 
way  or  another  that  your  attitude  towards  him,  if  he  should 
break  out  with  such  language,  would  be  no  more  contemp- 
tuous, crushing  or  sniffling  than  if  he  should  break  out  with 
measles. 


THE  DEFORMING  INFLUENCES  OF  THE  HOME 


BY  HELEN  WILLISTON  BROWN,  M.  D. 

TRADITION  asserts  that  the  home  is  the  most 
valuable  asset  and  institution  of  which  we  are 
possessed.  It  is  associated  in  the  minds  of  the 
people  with  morality  and  religion  and  surrounded 
by  a halo  of  affection  and  sentiment.  Any  innovation  in 
government  or  society  is  observed  from  the  point  of  view  of 
what  effect  it  may  have  upon  the  home,  and  anything 
that  would  threaten  its  stability  has  been  regarded  as  an 
enemy  of  civilization.  Oratory  and  eloquence  have  been 
poured  out  upon  it.  Its  praises  have  been  repeated  in  song 
and  story,  and  it  is  generally  admitted  that  the  bonds  of 
parental  affection  are  the  most  enduring  in  the  world. 

To  many  of  those  who  have  had  a religious  upbringing, 
the  statement  that  the  parents  stand  in  the  place  of  God 
himself,  to  the  young  child,  is  entirely  familiar,  and  this  idea 
has  been  strengthened  and  given  weight  by  the  similar 
nomenclature  applied  to  both  the  male  parent  and  the 
Deity,  and  also  by  the  aureole  of  divinity  that,  though  some- 
what obscured,  has  lingered  round  the  mother  since  matri- 
archal days.  In  the  past  many  children  have  been  taught 
to  accept  this  point  of  view,  and  it  has  lent  weight  to  the 
authority  with  which  parents  have  been  accustomed  to 
impose  their  own  opinions  and  beliefs  upon  their  offspring. 

The  average  child,  and  probably  even  the  average  adult, 
is  accustomed  to  think  of  the  home,  as  now  constituted, 
as  having  existed  in  remo/test  antiquity.  Many  of  us  have 
a mental  picture  of  the  “first”  home  outside  the  garden  of 
Eden,  with  Adam  tilling  the  soil,  and  Eve  tending  little  Cain 
and  Abel,  and  the  effect  of  this  mental  picture  is  not  by  any 
means  entirely  destroyed,  as  yet,  by  our  own  theoretical 
knowledge  of  evolution. 

But  though  the  idea  of  a home,  made  up  of  father  and 
mother,  and  children  to  whom  the  father  and  mother  have 


49 


5° 


The  Deforming  Influences  of  the  Home 


the  exclusive  right  of  giving  authoritative  teaching  in  their 
early  years,  forms  a normal  part  of  our  mental  furniture, 
greater  knowledge  is  tending  to  widen  our  horizons,  and  to 
raise  questions  as  to  the  continuity  in  the  past  and  future, 
of  present  conditions.  We  know  now,  though  we  may  not 
feel  it,  that  the  Home  and  Family  have  been  very  variable 
institutions,- — that  instead  of  Adam  and  Eve,  we  have  the 
horde,  mating  more  or  less  at  random.  Their  offspring,  were 
children  of  the  horde,  and  doubtless  had  the  advantage  of 
all  the  knowledge  possessed  by  the  horde  and  not  merely  of 
two  individuals.  Later  there  was  group  marriage  and  then 
matriarchy  with  the  family  still  loosely  defined.  Patriarchy 
with  polygamy  succeeded,  and  finally,  in  the  so-called 
civilized  races,  monogamy  became  the  ideal  form  of  union 
in  which  to  rear  children.  So  that  it  is  only  in  comparative- 
ly recent  times,  that  the  home,  as  we  now  know  it,  has 
existed. 

Perhaps  it  is  in  this  country,  in  New  England  of  a 
century  ago,  that  the  home,  so  constituted,  was  found  in  its 
most  extreme  type,  where  in  a democracy,  without  church 
or  state  that  would  intervene,  many  parents  felt  themselves 
directly  responsible  to  God,  not  only  for  the  physical  welfare 
of  their  children,  but  for  their  souls  as  well,  and  to  this  end, 
impressed  their  own  personalities  and  teachings  upon  their 
offspring  with  vigor  and  conviction.  Backed  up  by  “reve- 
lation” and  urged  on  by  fears,  the  narrowness  of  such  a 
course  never  seems  to  have  occurred  to  them,  and  only  in 
recent  years  have  suspicions  begun  to  arise  that  home  ties 
can  be  too  rigid,  and  that  the  child  should  be  allowed  to 
acquire  the  mental  inheritance  of  the  race,  rather  than  that 
small  and  distorted  portion  of  it  found  in  two  individuals. 

Home  ties  and  home  teaching  have  been  considered  as 
the  shield  and  buckler  with  which  youth  has  been  enabled 
to  guard  itself  against  an  evil  world,  and  the  possible  harm- 
fulness of  such  ties  and  training  to  the  child  they  are  sup- 
posed to  protect,  is,  as  I have  said,  a very  modern  idea.  T 
do  not  allude  to  the  influences  of  early  infancy,  when  to  any 
one  but  a mother  or  a Freudian,  the  intelligence  of  the  child 
appears  negligible,  but  to  the  time  when  the  child  becomes 
interested  in  other  than  purely  material  problems,  and  turns 


Helen  Willis  ton  Brown 


51 

to  its  parents,  with  absolute  confidence  in  their  knowledge 
and  veracity,  for  information  concerning  life.  Far  too  few 
parents  have  the  wisdom  or  desire  to  refrain  from  the 
opportunity  thus  presented  to  didactically  impress  their 
own  views  as  ultimate  reality,  upon  their  confiding  offspring; 
and  not  their  views  alone,  but  along  with  them,  their  affects, 
their  prejudices,  their  fears  and  their  egocentricities,  which 
the  child  trustfully  accepts  and  imitates.  A heavy  burden 
for  the  child  to  carry  forth  into  a world  where  theoretically 
he  should  walk  a free  man  among  free  men,  heir  to  all  the 
wisdom  of  the  ages. 

Small  wonder,  then,  if  we  begin  to  see  that  many  of  the 
mental  ills  that  afflict  man,  are  not  due,  as  has  been  common- 
ly supposed,  to  lack  of  home  training  and  the  deteriorating 
influence  of  the  world,  but  to  too  much  home,  to  a narrow 
environment  which  has  often  deformed  his  mind  at  the  start 
and  given  him  a bias  that  can  only  be  overcome  through 
painful  adjustments  and  bitter  experience. 

Freud  has  pointed  out  that  there  is  an  antagonism  be- 
tween individuals,  between  father  and  son,  mother  and 
daughter;  and  Trotter,  generalizing,  has  shown  that  there  is, 
as  well,  an  antagonism  between  succeeding  generations 
which  has  led  to  a lack  of  frankness  between  them,  and  has 
caused  the  older  generation  to  pass  on  to  the  younger,  in 
its  childhood,  a mass  of  untrustworthy  tradition,  which 
heavily  encumbers  the  mind  of  the  latter  in  its  efforts  to 
meet  the  actual  world,  and  causes  conflict  and  instability 
among  the  more  sensitive  members. 

Trotter  describes  mankind  as  a herd,  and  admits  the 
existence  of  herds  within  the  herd,  but  he  does  not  continue 
on  to  the  final  subdivision, — the  individual  home,  which 
undoubtedly  constitutes  the  herd  of  the  young  child.  He 
points  out  that  the  influence  of  the  herd  upon  its  members, 
is  overpowering,  and  that  it  can  and  does  combat  on  equal 
terms  the  fundamental  instincts  of  mankind.  Thus  is 
caused  continual  upheaval  and  discord  among  adolescents 
who  find  their  own  instincts  at  odds  with  their  training.  It 
follows  that  the  narrower  and  more  authoritative  their  train- 
ing,— the  less  it  takes  into  account  actual  existing  conditions, 
— the  more  it  teaches  untruth, — either  by  implication  or 


52 


The  Deforming  Influences  of  the  Home 


direct  word  of  mouth, — so  much  the  worse  it  will  be  for  the 
youthful  individual  when  finally  joining  the  larger  herds, 
and  acquiring  broader  knowledge,  he  finds  himself  con- 
fronted from  within  and  from  without  by  contradictions 
and  denials  of  much  that  he  has  been  led  to  consider  ultimate 
reality.  He  will  find  his  instincts  of  self-preservation  and 
sex,  which  had  been  kept  in  abeyance  as  far  as  possible  by 
care  and  repression,  loom  up  into  consciousness  as  tremend- 
ous problems,  and  he  will  see  the  herd  meeting  these  problems 
in  many  different  ways  according  to  the  subdivisions  to  which 
they  belong, — according  not  only  to  their  age  and  genera- 
tion, but  to  the  type  of  home  training  they  have  received. 
He  will  probably  be  tremendously  shocked  to  find  himself 
and  all  the  world  turned  traitor  to  the  traditions  of  his  child- 
hood. Adjust  he  will  because  adjust  he  must,  unless  he  is 
to  go  down  whimpering  to  defeat,  but  with  what  a mass  of 
false  visual  images  he  will  have  to  contend;  at  what  pains  he 
will  be  to  wipe  them  out  by  wider  thinking,  only  to  find  them 
peering  again  insistently  from  the  darkness! 

The  individual  with  the  dogmatic  religious  rearing 
probably  has  the  most  to  contend  with,  but  that  is  a con- 
dition happily  much  rarer  at  the  present  day  when  religious 
instruction  to  children  is  usually  so  vague  as  not  to  inspire 
any  very  vivid  reaction,  but  there  are  other  lines  of  in- 
struction calculated  to  create  trouble  that  are  by  no  means 
as  yet  abolished.  Take  for  example  the  romantic  idealism 
taught  to  little  girls,  the  tremendous  endeavor  to  shield 
their  lives  from  the  knowledge  of  evil  and  suffering  and  the 
problems  of  sex.  There  was  a time  when  some  women  were 
so  shielded  through  life  that  they  stood  a chance  of  never 
seeing  reality,  but  more  recently  women  have  been  reared 
in  one  tradition  to  live  in  another,  and  we  see  the  harmful 
result  in  many  ways, — in  their  hysterical  efforts  to  force  the 
world  to  be  what  they  had  thought  it, — in  their  intense 
horror  at  existing  conditions,  since  to  them  the  world  seems 
fallen  from  some  previously  existing  beatific  state,  rather 
than  to  have  progressed  from  even  cruder  and  crueller 
origins. 

It  is  only  where  fact  comes  in  conflict  with  previous 
teaching  that  it  inspires  undue  horror,  otherwise  it  is  ac- 


Helen  Williston  Brown 


53 


cepted  reasonably  enough,  and  it  must  be  said  to  the  credit 
of  the  present  generation  that  though  parents  may  still  tend 
to  bring  up  their  children  in  unreality,  yet  thanks  to  the 
pressure  from  the  world  at  large,  they  initiate  them  much 
earlier  than  of  old  into  fact. 

Is  it  not  probable  that  the  reason  women  of  the  United 
States  have  been  notably  over-emotional  and  often  badly 
adjusted,  lies  in  this  very  dissociation  between  their  early 
youth  and  their  later  lives,  and  their  bitter  struggles  to 
adjust  from  one  to  the  other?  It  has  been  my  observation 
that  the  women  who  have  been  early  initiated  into  the 
inherent  cruelties  and  hardships  of  existence  are  likely  to  be 
of  a much  more  stable  and  stalwart  stuff  than  their  more 
sheltered  sisters,  and  though  they  may  be  lacking  in  the 
provocative  charm  arising  from  ignorance  and  half  knowl- 
edge, no  one  can  grudge  them  their  happy  acceptance  of  fact. 

It  frequently  is  not  so  much  the  trials  and  hardships 
with  which  the  individual  must  contend  that  may  destroy 
him,  as  an  abnormal  way  of  regarding  them,  or  an  abnormal 
affect  towards  them,  and  these  abnormal  points  of  view  and 
affects  are  likely  to  be  cultivated  in  narrow  homes.  The 
children  of  the  poor  have  a better  chance  to  get  things 
straight.  They  live  in  closer  contact  with  their  neighbors 
and  can  not  be  kept  from  a knowledge  of  fundamental  things. 
They  cannot  be  coddled  and  pampered  as  are  children 
“better  off”  and  there  is  therefore  less  danger  that  they  will 
think  too  highly  of  themselves.  The  rich  child  early  per- 
ceives that  he  is  the  object  of  intense  solicitude;  his  pains 
and  aches  are  the  subject  of  grave  inquiry;  his  happiness  is 
furthered  as  essential  to  his  well  being,  and  he,  reasonably 
enough,  reaches  the  conclusion  that  he  is  a person  of  some 
importance  who  has  a right  to  be  preserved  from  the  ills 
of  the  common  herd.  This  attitude  is  proverbially  knocked 
out  of  him  at  school  and  college,  but  I imagine  it  is  often 
merely  knocked  under  rather  than  out,  and  may,  unless  he 
has  the  wit  to  see  its  falseness,  persist  through  life.  Thus 
the  home  often  lays  a foundation  of  egocentricity  far  exceed- 
ing the  amount  necessary  in  the  struggle  for  existence, 
which  may  make  life  exceedingly  difficult  and  bitter  for  its 
possessor. 


54  The  Deforming  Influences  of  the  Home 

The  home  may  be  not  only  an  excellent  place  for 
cultivating  ideas  of  undue  importance  but  for  inculcating 
prejudices  as  well.  Much  of  the  positiveness  and  intoler- 
ance of  the  child  arises  directly  from  the  training  of  his 
parents,  who,  eager  that  their  children  should  believe  what 
they  consider  desirable,  often  refrain  from  telling  them  that 
others  may  as  ardently  hold  opposite  opinions,  or  if  they  are 
forced  to  admit  the  existence  of  opposite  opinions,  authori- 
tatively declare  them  to  be  wrong. 

Concerning  their  affects  and  their  fears, — parents  hand 
them  on  for  the  most  part  unconsciously,  but  none  the  less 
with  the  dire  force  possessed  by  those  who  are  supposed  to 
be  endowed  with  superior  wisdom  and  intelligence. 

So  much  for  an  indictment  of  the  home  as  it  too  often 
is.  There  are  many  other  sins  of  omission  and  commission 
that  might  be  mentioned,  and  there  is  of  course,  the  reverse 
side  of  the  picture  with  which  we  are  all  familiar  and  which 
needs  no  further  emphasis. 

I have  tried  to  make  evident  that  the  home  represents 
the  last  and  the  narrowest  division  of  the  herd,  and  that  as 
such  it  wields  tremendous  power  over  the  mind  of  the  child. 
It  acts  as  the  transmitter  of  what  may  be  the  least  desirable 
of  herd  tradition  and  this  tradition  is  often  further  distorted 
by  the  idiosyncracies  of  the  parents,  and  administered 
ex  cathedra  as  unquestionable  truth.  Thus  handicapped 
the  child  goes  forth  to  conflict  with  the  world,  where,  after 
a period  of  unrest  and  readjustment  he  will,  if  he  is  fortunate, 
join  some  herd  wherein  his  .soul  may  find  companionship. 

Trotter  has  pointed  out  that  there  is  no  herd  existing 
so  enlightened  as  not  to  distort  to  some  extent  the  mind  of 
man.  He  feels  that  the  human  herd,  as  a whole,  tends  to 
repress  and  deform  the  individual,  and  to  drive  him  into 
one  of  two  camps  which  he  calls  the  resistive  and  the  un- 
stable. 

In  the  resistive  class  are  those  who  are  most  susceptible 
to  herd  influence,  who  accept  the  teachings  of  the  herd, 
harden  their  hearts  to  the  sufferings  of  others,  rationalize 
their  actions  to  justify  themselves,  and,  in  their  purest  type 
would  probably  proclaim  this  to  be  “the  best  of  all  possible 
worlds.”  Into  this  class  for  the  most  part  arrive  those  in- 


Helen  Williston  Brown 


55 


dividuals  who  have  in  their  youth  most  docilely  accepted  the 
authoritative  training  of  narrow  homes,  who  have  refused 
to  be  too  much  aroused  in  the  soul-stirring  educational 
period  of  their  adolescence,  and  whose  minds  as  a result 
function  most  comfortably  in  a stable,  unprogressive,  and 
visionless  medium.  Thus  they  make  up  the  well-known 
class  bitterly  opposing  progress  and  reform. 

The  unstable,  on  the  other  hand,  in  Trotter’s  use  of  the 
term,  are  those  who  are  essentially  capable  of  vision,  either 
as  a result  of  wider  environment  or  inherent  capacity.  They 
tend  to  question  authority;  they  tend  to  feel  the  pressure  of 
problems  beyond  their  own  immediate  circle;  they  are  deeply 
dissatisfied  with  existing  conditions;  their  youth  is  full  of 
conflicts  and  revolts;  they  resent  traditional  training  and 
react  violently  against  it,  although  unable  to  break  away 
from  it  entirely.  The  world  as  it  is  now  constituted,  has 
small  place  for  them,  and  as  a result  they  are  likely  to  end 
as  cranks  and  asocial  individuals,  or  to  crowd  themselves 
uncomfortably  into  niches  unsuited  for  them,  from  which 
they  constantly  complain  and  disturb  the  quiet  of  their 
resistive  neighbors. 

Mathew  Arnold  gave,  years  ago,  an  admirable  descrip- 
tion of  these  two  types  in  his  poem  entitled  “ A Summer 
Night.” 


“For  most  men  in  a brazen  prison  live, 

* * * * 

Dreaming  of  nought  beyond  their  prison-wall. 
And  as,  year  after  year, 

Fresh  products  of  their  barren  labour  fall 
From  their  tired  hands,  and  rest 
Never  yet  comes  more  near, 

* * * * 

Death  in  their  prison  reaches  them, 

Unfreed,  having  seen  nothing,  still  unblest. 


56 


The  Deforming  Influences  of  the  Home 


And  the  rest,  a few, 

Escape  their  prison  and  depart 
On  the  wide  ocean  of  life  anew, 

There  the  freed  prisoner,  where’er  his  heart 
Listeth  will  sail; 

Nor  doth  he  know  how  there  prevail, 

Despotic  on  that  sea, 

Trade-winds  which  cross  it  from  eternity. 

* * * =t= 

And  then  the  tempest  strikes  him;  and  between 
The  lightning-bursts  is  seen 
Only  a driving  wreck 

And  the  pale  master  on  his  spar-strewn  deck 
With  anguished  face  and  flying  hair 
Grasping  the  rudder  hard,  ' 

Still  bent  to  make  some  port  he  knows  not  where. 

* * * * 

And  he  too  disappears,  and  comes  no  more. 

Is  there  no  life,  but  these  alone? 

Madman  or  slave,  must  man  be  one?” 

It  might  be  claimed  that  since  the  resistive  type  has 
survived  so  far,  it  should  continue  to  control  the  destinies  of 
mankind,  but  here  Trotter  raises  a warning  voice  and  affirms 
that  man  is  too  smugly  assured  of  his  destiny  as  the  ruler  of 
the  world,  and  he  paints  a black  picture  of  the  future  unless 
revolutionary  changes  are  made. 

As  to  the  truth  of  this  prediction  I suppose  we  cannot 
judge,  but  no  thinking  person  will  deny  that  if  society  as 
now  constituted  is  so  narrow  as  to  have  no  environment  or 
place  suitable  for  a class  of  individuals  who  are  inherently 
possessed  of  progressive  qualities,  then  society  is  at  fault, 
and  should  so  alter  itself  as  to  be  able  to  make  use  of  all  its 
valuable  material.  The  waste,  cruelty  and  suffering  of 
present  conditions  are  undeniable,  and  they  seem  to  arise  in 


Helen  Willi ston  Brown 


5 7 


great  measure  from  the  selfishness  and  lack  of  vision  of 
those  who  control.  Even  if  Trotter’s  black  prognostica- 
tions should  be  over-drawn,  the  remedy  of  altruism,  that  he 
offers,  is  assuredly  applicable  to  the  manifest  ills  of  the 
present  time.  In  altruism,  he  feels,  is  found  the  hope  of  the 
future,  and  by  its  means  he  thinks  men  could  so  get  together 
and  take  account  of  their  assets  as  to  utilize,  instead  of 
to  destroy  them.  By  this  procedure  mankind  might  attain 
to  a state  of  excellence  at  present  undreamed  of. 

If  then  altruism  is  a good  and  possibly  an  essential 
condition  for  the  future  of  the  race,  I should  like  to  emphasize 
a way  to  pursue  the  reforms  that  would  lead  to  it,  namely  in 
education  and  instruction  that  shall  take  effect  in  the  home. 

I have  reviewed  how  in  early  times  the  home  had  a 
wider  significance  than  at  present,  and  how  the  children  of 
the  past  had  the  benefit  of  more  general  herd  influence,  how 
the  home  gradually  narrowed  down  to  its  present  limitations, 
wherein  the  young  are  too  often  subjected  to  narrow  and 
selfish  teaching,  dealt  out  with  authority  by  their  parents. 
I make  no  objection  to  the  present  constitution  of  the  home, 
but  it  would  seem  that  if  parents  could  be  brought  to  consider 
their  children  as  children  of  the  world  as  well,  and  as  there- 
fore entitled  to  the  broadest  possible  training  and  interests, — 
to  realize  themselves  as  merely  units  in  the  general  order  of 
things,  to  feel  themselves  bound  by  ties  of  self-interest  and 
unselfishness  to  all  other  human  beings, — 'much  would  have 
been  done  to  remove  the  causes  of  conflicts  which  prevent 
the  orderly  development  of  men’s  minds,  and  to  foster  the 
cause  of  altruism  on  which  man’s  future  survival  and 
existence  may  depend. 


THE  MEANING  OF  PSYCHOANALYSIS 


TRIGANT  BURROW,  PH.  D.,  M.  D. 


“ Know  then  thyself , presume  not  God  to  scan , 
The  proper  study  of  mankind  is  man.” 

Alexander  Pope. 


IN  distinct  contrast  to  programs  of  psychotherapy,  which 
lacking  the  basis  of  definite  formulation,  are  open  to 
different  interpretations  according  to  the  personal 
equation  of  the  physician,  psychoanalysis  rests  upon  a 
single  scientific  principle  and  hence  variations  of  construc- 
tion due  to  individual  reaction  are  incompatible  with  the 
specific  acceptance  of  its  tenets. 

By  specific  psychoanalysis  I mean  the  psychoanalysis 
that  is  synonymous  with  Freud.  Psuedo-psychoanalytic 
principles  modified  according  to  pleasure,  while  doing  credit 
to  the  ingenuity  of  their  inventors,  have  departed  funda- 
mentally from  the  principle  of  Freud.  | The  psychoanalysis 
of  Freud  has  the  distinguishing  mark  that  it  is  precisely  not 
subject  to  alteration  according  to  personal  delectation 
One  may  take  it  or  leave  it,  but  it  is  useless  to  haggle. 

The  psychoanalysis  then  that  is  here  under  discussion 
presents  the  distinctive  stamp  of  Freud.  In  substance, 
that  stamp  is  inscribed  as  follows:  Psychoanalysis  is  a 

*Read  at  the  7th  Annual  Meeting  of  the  American  Psychopathological  Associa- 
tion at  Washington,  D.  C.,  May  12,  1916. 

|To  speak  of  different  “schools”  of  psychoanalysis  in  the  sense  of  different 
underlying  principles  of  psychoanalysis  is  to  labor  under  a misapprehension.  One 
might  as  well  talk  of  different  schools  of  chemistry  or  of  bacteriology.  There  may 
of  course  be  innumerable  schools  of  philosophy  differing  from  each  other  according 
to  the  type  of  compensative  reaction  presented  in  the  innocuous  speculations  of 
the  particular  philosopher.  But  psychoanalysis  is  not  a philosophy.  It  is  a 
science  and  therefore  based  upon  definite  principles.  So  that  schools  of  psycho- 
analysis differently  located  geographically  must  not  be  confused  with  schools 
based  upon  different  scientific  principles.  A “School”  of  psychoanalysis  in  this 
sense  is  a logical  misnomer.  The  utmost  that  might  be  included  by  way  of  differ- 
entiation, in  the  term  “school,”  aside  from  the  distinction  of  locality,  could  only 
be  such  divergencies  of  inference  or  extensions  of  principle  as  follow  from  and  are 
fully  compatible  with  the  teachings  of  Freud. 


Trigant  Burrow 


59 


method  of  psychotherapy  based  upon  the  principle  that 
where  there  is  present  marked  and  persistent  impediment 
in  che  life  of  the  individual,  whether  it  amounts  to  the 
blocking  characteristic  of  nervous  disorders  or  only  to  such 
obstruction  of  effectiveness  as  is  represented  in  many  so- 
called  normal  individuals,  it  is  due  to  the  existence  in  the 
psyche  of  unconscious,  that  is,  repressed  sexual  affects, 
regressing  toward  an  early,  infantile  mode. 

This  statement  is  apparently  simple,  enough  to  be 
adapted  to  the  perceptions  of  all,  yet  oddly  enough  by  some 
fatal  tendency  of  the  human  mind,  it  invariably  misses  the 
central  point  of  this  psychoanalytic  principle.  That  point 
is  this:  that  in  its  basic  postulate  of  repression  as  the  causa- 
tive factor  in  the  neuroses,  we  have  not  to  do  with  a patho- 
logical but  with  a biological  principle,  and  that  therefore 
psychoanalysis  does  not  incriminate  the  nervous  invalid 
alone,  but  along  with  him  the  whole  social  organism.  It  is 
not  alone  an  indictment  of  our  patients  but  of  ourselves.  It 
does  not  contrast  the  normal  and  the  neurotic  personality 
as  unrelated  genera,  but  sees  unabashed  the  line  of  unbroken 
gradation  between  these  types.  The  essential  idea  then  of 
psychoanalysis  is  the  personal  analysis.  It  is  not  the 
analysis  of  our  patients,  it  is  the  analysis  of  ourselves.  If 
one  has  lacked  the  opportunity  or  the  patience,  or  the  cour- 
age, to  face  the  personal  analysis  in  all  its  rigor,  he  is  unac- 
quainted with  psychoanalysis.  He  is  lacking  in  the  essential 
data.  He  is  counting  without  his  host. 

This  is  the  rub,  I know.  This  is  the  impassable  barrier 
between  the  psychoanalyst  and  the  psychopathologist  of 
other  tendencies.  The  difference  though  is  irreconcilable. 
When  this  position  shall  be  compromised  psychoanalysis 
will  have  gone  by  the  board.  Yet,  as  essential  as  this 
position  is  to  the  right  interpretation  of  psychoanalysis,  I 
cannot  recall  it  without  deep  misgiving,  as  I am  not  una- 
ware to  what  extent  psychoanalysis  has  been  brought  into 
disrepute  by  those  youthful  psuedo-psychoanalytic  poseurs 
who  in  the  insolence  of  their  half  baked  opinions  have  seized 
this  position  as  an  apparent  coign  of  vantage,  from  which  to 
disguise  their  own  triviality,  and  to  derogate  from  the  high 


60  The  Meaning  of  Psychoanalysis 

and  enduring  achievements  of  their  colleagues  of  other 
schools. 

And  so,  in  reasserting  the  necessity  of  the  personal 
experience  as  a prerequisite  to  a sympathetic  understanding 
of  psychoanalysis,  I trust  earnestly  that  this  position  may 
not  seem  inconsistent  with  a due  sense  of  one’s  own  limita- 
tions, nor  with  a relatively  high  appraisement  of  the  value 
and  significance  of  the  work  of  others. 

I wish,  then,  at  the  outset  to  avow  myself  in  all  essential 
respects  a firm  and  uncompromising  advocate  of  the  Freudian 
psychology,  and  in  what  follows  I hope  to  make  clear  the 
way  in  which  I have  personally  come  to  conceive  of  the 
problem  presented  in  psychoanalysis.* 

Having  expressed  my  complete  sympathy  with  the 
conception  which  ascribes  to  neurotic  disorders  repression 
within  the  sexual  life,  it  would  be  natural  to  anticipate  that 
this  discussion  will  be  chiefly  concerned  with  the  sexual 
topic — with  instances  of  sexual  repression,  with  illustrations 
of  its  mechanisms,  with  a recital  of  its  causes,  and  develop- 
ment. In  this  expectation,  however,  I shall  be  found  disap- 
pointing. While  sexual  repression  is  undoubtedly  the  pre- 
requisite cause  of  nervous  disorders,  sexual  instances  when 
they  fall  into  the  hourly  routine  of  laboratory  technique  are 
in  themselves  dull,  their  details  tedious.  Except  to  the 
mind  that  is  sexually  obsessed,  that  is  to  say  the  average 
mind,  such  reminiscences  are  only  entertaining  as  they  are 
found  to  bear  a constant  relation  to  an  invariable  principle. 
It  is  with  this  principle  that  I am  here  concerned. 

Let  me  hasten  to  offset  at  once  any  disposition  to  con- 
strue this  statement  as  an  inference  of  the  slightest  reserva- 
tion in  my  acceptance  of  the  sexual  factor  as  specifically 
demonstrated  by  Freud.  In  delving  amid  the  archaeological 
strata  of  unconscious  fantasy,  one  comes  too  often  upon 
unmistakable  anthropological  analogies  to  admit  of  any 
theoretical  impediment.  And  as  regards  the  matter  of 
personal  resistances,  I believe  I am  quite  honest  in  saying 

*Perhaps  this  is  a fitting  occasion  to  express  my  acknowledgement  of  the  very- 
unusual  impetus  I have  been  given  for  the  study  and  analysis  of  neurotic  disorders. 
For  this  opportunity  I am  indebted  to  Dr.  Adolf  Meyer,  to  whom  I owe  this  fortu- 
nate occasion,  and  whose  helpful  suggestions  have  been  to  me  at  all  times  an  in- 
dispensable assistance. 


Trigant  Burrozv 


61 


that  I accept  without  perturbation  whatsoever  sexual 
divertissements  may  be  featured  throughout  the  entire 
theatrical  circuit  of  regressive  autisms.  So  that  in  denying 
to  the  sexual  factor  per  se  the  place  of  central  interest  in 
psychoanalysis,  it  is  not  because  the  sexual  factor  does  not 
seem  to  me  present  and  inevitable,  but  because  it  does  not 
seem  to  me  the  point. 

What  then  is  the  point  of  psychoanalysis?  What  is 
the  invariable  principle  upon  which  psychoanalysis  rests? 
I remember  at  the  Fourth  Psychoanalytic  Congress  held  in 
Nuremberg  in  the  year  1911,  how  Freud  himself  defined 
the  essential  meaning  of  psychoanalysis,  and  I recall  too 
something  of  the  surprise  with  which  his  words  were  re- 
ceived by  some  of  us  of  the  Zurich  school,  where  at  that 
time,  it  was  not  resistances,  but  “complexes”  which  oc- 
cupied the  foreground.  “It  is  not,”  Freud  said,  “the  dis- 
covery and  counting  and  tabulating  of  complexes  that  is 
the  object  of  psychoanalysis,  but  the  sole  object  of  psycho- 
analysis is  the  overcoming  of  a patient’s  resistances.” 

I suppose  I am  stupid,  but  it  was  a long  time  before  I 
comprehended  fully  the  real  import  of  this  statement. 
Perhaps  it  was  its  very  simplicity  that  baffled  me.  Or  was 
I viewing  it  at  too  close  range  to  allow  of  the  necessary 
accommodation  of  vision?  At  any  rate,  it  has  now  become 
clear  to  me  that  the  whole  point  of  psychoanalysis  reduces 
itself  to  a question  of  resistances  and  that  the  meaning  of 
psychoanalysis  becomes  synonymous  with  the  psychology 
of  resistances.  Let  us  then  examine  this  conception  of 
resistances,  with  a view  to  determining  correctly  its  psycho- 
logical relation  to  the  problem  of  the  neuroses. 

When  we  consider  the  prohibitions  with  which  life  is 
hedged  around  from  its  earliest  beginnings — how  from  their 
earliest  years  children  are  beset  with  unnecessary  denials 
and  negations, — how  incessantly  their  little  industries  and 
investigations  are  checked  with  admonition  and  warning 
and  threat,  perhaps  even  with  physical  restraint  and  punish- 
ment, and  how  all  these  interdictions  and  thwartings  of 
their  natural  impulses  are  effected  through  the  invocation 
of  some  ominous  and  vaguely  apprehended  sense  of  “wrong,” 
we  begin  to  realize  how  deeply  the  minds  of  children  are 


62 


The  Meaning  of  Psychoanalysis 


imbued  with  ideas  of  an  all-pervading,  if  indefinable  pre- 
monition of  evil,  and  we  begin  to  sense  something  of  the 
superstitious  awe  with  which  life  is  polluted  almost  at  its 
very  source. 

“Don’t  do  that,”  they  are  told,  “because  it  is  had , it 
is  wicked . ” Frequently  the  prohibition  is  accompanied  by 
direct,  if  equally  indeterminate  intimations  of  retributive 
pain,  such  as  “God  will  punish  you,”  or  “Something  dread- 
ful will  happen  to  you.”  Sometimes  it  is  the  “Evil  One” 
himself,  who,  they  are  warned,  will  overtake  them.  And  so 
actuated  by  an  instinct  of  self-preservation,  this  early  incul- 
cated fear  becomes  the  predominating  motive  of  conduct  in 
later  life,  and  if  we  will  consider  it  we  shall  see  that  even  in 
adult  life  not  only  is  the  conduct  of  the  masses  wholly  under 
the  sway  of  such  a fear  inhibition,  but  that  the  motives  of 
the  more  intelligent  are  by  no  means  untainted  by  this  secret 
incentive  of  fear. 

Now,  upon  examination,  it  turns  out  that  this  fear 
inhibition  is  the  active  principle  of  the  universally  accepted 
code  of  behaviour  commonly  described  as  morality.  By 
morality,  as  here  defined,  I mean  an  emotional  evaluation 
of  right  and  wrong  inculcated  upon  a basis  of  apprehension — 
the  slavish  conformity,  through  which  we  seek  to  evade 
the  deeper,  organic  morality  that  is  one  with  the  ultimate 
processes  of  life.  For  we  contend  that  when  motives  of 
right  and  wrong  represent  reactions  toward  or  away  from  a 
given  course  of  action  merely  in  virtue  of  a blindly  accepted, 
that  is  unconscious,  principle  of  fear,  there  is  present  an 
entirely  fictitious,  emotional  morality. 

Now  such  a morality  constituting  an  obstacle  to  the 
normal  flow  of  consciousness  is  the  essential  factor  which 
confronts  us  in  psychoanalysis  and  it  is  this  factor  which  in 
its  deadly  affront  to  organic  law  is  known  to  us  as  a resistance. 
Whether  occurring  in  the  more  marked  discrepancies  pre- 
sented in  the  intenser  reactions  of  the  nervous  invalid,  or 
in  the  commonly  condoned  extravagancies  and  vagaries 
symptomatic  of  so-called  normal  human  society,  it  is  this 
factor  of  resistance  with  its  attendant  conflict  within  the 
personality  which  psychoanalysis  envisages  as  the  sole 
account  of  neurotic  manifestations. 


Trigant  Burrow 


63 


A resistance  then  may  be  described  as  a blind  emotional 
bias,  whereby  we  are  permitted  to  see  things  according  to 
preference  rather  than  as  the  facts  warrant.  Abrogating 
the  course  of  intelligence  and  truth,  resistances  allow  us  to 
blink  the  facts  of  life  and  indulge  in  pleasanter  alternatives.* 

*An  instance  selected  from  my  record  of  a case  seen  at  the  Phipps  Psychiatric 
Dispensary  of  the  Johns  Hopkins  University,  illustrates  how  characteristically 
complicated  a mechanism  may  result  from  this  factor  of  resistance. 

A man  of  thirty  suffered  for  a period  of  five  years  from  an  obsessional  condi- 
tion which  centered  in  the  idea  of  serious  digestional  disturbance,  a marked  symptom 
of  which  consisted,  according  to  the  patient,  of  his  liability  to  involuntary  stools 
under  the  stimulus  of  the  least  excitement — a menace  which  obliged  him  to  with- 
draw almost  entirely  from  social  contact.  Such  was  the  complaint  which  caused 
the  patient  to  seek  treatment. 

Although  the  patient  was  unswerving  in  his  insistence  upon  the  abdominal 
condition,  and  quite  typically  bent  all  his  energies  toward  engaging  my  attention 
exclusively  upon  the  alleged  disturbance,  as  far  as  discoverable  there  was  no  objec- 
tive ground  for  the  symptom  which  lead  to  his  seclusiveness,  physical  examination 
and  X-ray  having  failed  to  reveal  a condition  even  remotely  commensurate  with 
the  subjective  symptoms. 

It  was  only  after  many  weeks  of  study  that  the  real  disturbance  suspected  as 
lying  back  of  these  obvious  symptoms  began  at  last  to  show  itself  in  intimations 
of  an  underlying  religious  conflict.  With  the  utmost  reluctance  and  pain  came 
the  acknowledgment  one  day  of  a vow  he  had  made  himself  as  a youth,  on  the 
occasion  of  a temporary  breach  with  his  mother,  that  if  he  might  be  saved  from 
damnation  he  would  become  a Roman  Catholic. 

Note  the  attempt  toward  the  appeasement  of  guilt  with  its  obvious  motivation 
in  a fear  reaction.  It  should  be  mentioned  that  consciously  the  patient  enter- 
tained no  belief  whatever  in  Roman  Catholicism  nor  in  the  doctrine  of  retributive 
damnation.  Yet  here  was  his  unalterable  vow,  which,  despise  as  he  would  intellec- 
tually could  not  be  got  rid  of.  He  was  as  incapable  of  fulfilling  it  as  of  dismissing 
it,  and  his  mind  was  constantly  torn  between  the  issues  involved  in  either  alternative. 

At  this  time  it  developed  that  there  existed  a distinct  causal  relation  between  the 
patient’s  mental  wrangles  and  the  digestional  distubances.  When  the  relig- 
ious conflict  was  at  its  height,  the  digestional  paroxysms  rose  to  a corresponding 
intensity.  At  the  same  time  there  was  being  gradually  unfolded  a history  of  the 
long  standing  antagonism  between  the  patient  and  his  mother — an  antagonism 
which  showed i tself  in  constant  irritation  and  discord. 

In  the  meantime,  the  analysis  of  the  patient’s  dreams  was  proceeding  steadily 
from  day  to  day  with  always  a deepening  incrimination  with  respect  to  the  sexual 
element.  With  the  increasing  refinement  of  the  analysis  it  was  shown  that  the 
patient’s  erogenous  interest  was  strongly  fixated  in  the  digestional  tract,  and  particu- 
larly in  the  lower  bowel,  and  here  was  involved  the  strongly  repressed  mother-fixa- 
tion, by  reason  of  the  intimate  and  apparently  very  exaggerated  solicitude  of  the 
latter  in  the  local  hygiene  of  the  patient  during  the  .period  of  his  infancy. 

These  primary  sexual  affects,  with  their  original  infantile  fixation,  analysis 
showed  were  related  with  early  masturfeatory  trends  which  subsequently  were 
replaced  by  repression,  through  a fear  reaction,  associated  with  threat  and  punish- 
ment from  the  mother.  Later,  in  response  to  this  element  of  prohibition,  the  con- 
flicting emotions  in  respect  to  the  mother  were  transposed  to  a religious  sphere, 
retaining  the  marks  of  their  original  design,  not  only  through  the  evidence  afforded 
through  the  dream  imagery,  but  through  their  association  with  the  concomitant 
digestional  episodes.  Determining  all  these  vicarious  phases  there  is  the  element 
of  resistance — the  dread  of  discovery,  the  repugnance  to  acknowledgment,  the 
resentment  and  shame  representing  the  conflict  and  pain  incident  to  an  underlying 
fear-morality. 

Here  in  this  situation  of  marked  obsessional  neurosis  is  presented  the  typical 
case  in  which  resistances  with  all  their  attendant  inhibitions  assume  the  domination 
of  the  entire  personality. 


64 


The  Meaning  of  Psychoanalysis 


If  this,  then,  is  resistance, — if  this  is  the  obstacle  which 
so  crushes  the  spirit  of  the  neurotic  patient  and  causes  him 
the  pain  and  stagnation  of  interest  characteristic  of  psychic 
disorders,  it  would  appear  to  be  the  task  of  the  psycho- 
analyst to  liberate  the  minds  of  these  patients  from  the 
incubus  of  their  besetting  morality.  If  fear-morality  is  the 
stumbling  block  to  the  health  of  the  nervous  patient,  and 
if  “fear-morality”  is  merely  an  altered  spelling  of  “resist- 
ances,” the  truth  of  Freud’s  statement  becomes  clear  when 
he  says  that  the  sole  recourse  of  psychoanalysis  is  to  rid 
these  invalids  of  their  resistances. 

Of  course,  there  immediately  rises  in  the  mind  the 
alarming  thought  of  the  dread  consequences  attending  a 
method  of  treatment  which  should  seek  to  remove  from  a 
patient  the  safeguards  of  moral  inhibition.  Such  a pro- 
cedure seems  to  threaten  the  very  foundations  of  society. 
One  objects  that  were  it  not  for  morality,  immorality  would 
overrun  the  world.  Such  indeed  is  the  instinctive  protest 
upon  every  hand.  But  when  we  consider  it,  we  will  find, 
I think,  that  this  protest  is  incited  precisely  by  one’s  own 
fear-morality,  that  one’s  own  reaction  here  is  precisely 
that  of  the  neurotic  patient  himself,  when  he  is  first  brought 
to  confront  his  resistances.  One’s  immediate  reaction  is 
straightway  to  redouble  one’s  efforts  of  self  protection  by 
clinging  the  more  tenaciously  to  one’s  own  habitual  morali- 
ties. And  so  if  one  is  disquieted  at  what  seems  the  quite 
unmoral  position  of  psychoanalysis  in  proposing  the  abroga- 
tion of  resistances,  investigation  will  reveal,  I think,  that  the 
cause  is  equally  traceable  to  one’s  own  emotional  morality — 
to  this  same  superstitious  fear-principle  underlying  the 
morality  within  oneself. 

Flere  we  return  again  to  the  specific  import  of  pyscho- 
analysis.  Once  more  that  import  returns  upon  ourselves. 
We  repeat,  the  rationale  of  psychoanalysis  rests  upon  princi- 
ples which  are  biological  and  universal.  We  who  are  ac- 
counted normal  are  ourselves  not  wholly  without  a certain 
fear-morality.  We  too  have  resistances.  We  too  are  not 
without  an  underlying  fear-principle.  And  so  it  would 
appear  that  life  itself  at  its  present  level  of  integration  is 
largely  dominated  by  standards  of  conduct  which  are 


Trigant  Burrow 


65 


prompted  by  a craven  principle  of  fear.  Consider  how 
cunningly  human  nature  disguises  the  facts  of  life,  thinking 
to  escape  them;  how  conveniently  it  turns  to  self-conceited 
promises  and  illusions  in  order  to  evade  the  alternatives  of 
some  ineradicable  truth.*  And  what  a riotous  adventure  is 
made  of  this  vicarious  carnival  of  living  under  which  men 
seek  to  masquerade  the  gracious  art  of  life!  Truly  the 
spectacle  of  the  daily  reactions  about  us  is  to  nothing  more 
fitly  comparable  than  to  the  legendary  ostrich,  beguiling 
itself  with  illusions  of  security  by  burying  its  head  in  the 
sand. 

If,  then,  we  ourselves  have  in  us  this  element  of  fear- 
morality  as  a guiding  compass  to  direct  the  course  of  our 
behaviour,  very  naturally  to  propose  the  elimination  of  a 
patient’s  moral  resistances  seems  to  us  synonymous  with 
abandoning  him  to  all  the  hideousness  of  immorality.  In 
other  words,  viewing  the  incentives  of  conduct  from  the 
plane  of  our  present  level  of  adaptation,  our  eyes  can  dis- 
cern only  the  alternatives  of  morality  and  immorality,  as 
though  between  these  two  issues  lay  our  exclusive  choice. 

But  why  is  this  moral  revulsion  through  motives  of 
superstitious  fear  the  only  safeguard  against  wrong?  Why 
must  we  frighten  ourselves  into  the  acceptance  of  a fair 
course  of  conduct?  Why  set  around  our  lives  intimidations, 
repressions  and  alarms  in  order  to  preserve  our  conduct 
against  acts  prejudicial  to  the  highest  interests  of  the  in- 
dividual and  of  society?  It  is  by  the  test  of  questions  such 
as  these  that  psychoanalysis  calls  us  to  account.  And  with 
good  authority.  For  having  dared  to  look  into  the  deeper 
actualities  underlying  human  appearances  it  finds  that  the 
springs  of  men’s  motives  are  befouled  by  the  presence  of  an 
insidious  untruth.  Burrowing  beneath  the  surface  of  life 
it  finds  that  the  moral  customs  and  observances  of  men 
are  motivated  in  mere  cowardice  and  conventionality,  and 
it  dares  to  assert  that  their  morality  is  but  their  immorality 
thrust  out  of  sight.  Looking  into  the  heart  of  men’s  con- 
duct, it  sees  that  what  is  called  their  “morality”  is  but  a 

*A  not  uncommon  turn  of  the  tendency  to  distortion  is  that  in  which  a patient 
(needless  to  say  not  a sensitively  organized  type  of  personality)  preferring  to 
evade  his  own  inadequacies  of  character  lays  to  the  door  of  the  psychoanalyst 
precisely  those  qnalities  which  the  analysis  shows  to  be  his  own. 


66 


The  Meaning  of  Psychoanalysis 


pretense  of  good.  It  finds  that  rather  than  view  the  world 
in  its  truth  men  prefer  to  construct  a cosmogony  out  of  the 
materials  of  their  own  uncertain  fashioning.  They  do  not 
view  the  processes  of  life  simply,  calmly,  unafraid.  Instead, 
they  cling  to  safe  presuppositions,  to  easy  solutions,  to 
flattering  assumptions.  They  shape  things  to  the  mould  of 
their  personal  preferences,  and  when  their  gratuitous  notions 
clash  with  the  unalterable  facts  of  life  they  only  cling  to 
their  pleasant  cheats  and  to  their  comfortable  indulgences 
as  children  to  their  mother’s  skirts.  This  is  the  essence  of 
fear-morality.  This  is  the  significance  of  resistances. 

I do  not  believe  that  this  is  the  real  material  of  our 
human  kind.  I believe  that  life  is  wrought  of  a better 
fibre — that  its  motives  are  saner  than  this.  As  I have  come 
to  study  from  hour  to  hour  those  expressions  of  pain  em- 
bodied in  the  neuroses,  I cannot  but  view  them,  howsoever 
obvious  may  be  the  weaknesses  and  indirections  that  attend 
them,  as  integrative  processes  tending  toward  higher  levels 
of  adaptation,  and  the  suffering  of  These  patients  as  an 
earnest  of  this  better  element  lying  back  of  man’s  experi- 
ence.* 

It  will  be  seen  that  this  view  demands  a wholly  altered 
conception  of  the  mental  pain  that  finds  its  expression  in 
the  neuroses.  It  will  be  seen  that,  in  this  interpretation, 
such  pain  is  no  longer  to  be  regarded  as  the  signal  for  the 
help  that  is  found  in  a regime  of  coddling  security,  but 
rather  indicates  the  need  of  attaining  a larger,  saner  con- 
ception of  life;  that  there  is  here  not  the  moment  for  com- 
miseration but  encouragement;  that  in  these  conditions 
there  is  not  necessarily  an  indication  of  weakness  but  rather 
of  strength,  and  that  with  a clearer  understanding  of  the 
real  need  of  the  neurotic  patient,  his  self-inflicted,  pain  may  be 

*In  a letter  written  to  me  by  a student  during  an  interval  in  his  analysis, 
there  is  this  passage:  “My  unconscious  is  a bad  chap  most  of  the  time,  but  no 
wonder!  For  many  years  I have  kept  him  penned  up  and  chained  and  imprisoned 
in  a dark  cell.  He  has  been  growing  up  in  darkness,  where  he  could  feed  on  nothing 
but  badness,  where  all  his  efforts  at  goodness  were  so  turned  in  on  himself  that  they 
rotted  into  badness.  And  he  grew — on  the  very  stuff  of  which  he  was  made,  he 
grew  and  thrived.  He  could  not  do  otherwise.  He  was  penned  up;  either  sneered 
at  or  ignored  and  forgotten.  But  he  grew!  Denied  the  sunshine,  he  grew  as 
death  always  grows — out  of  life — life,  robbed  of  its  expression — into  an  unseen 
monster,  that  slowly  but  eventually  destroys  the  life  that  gave  it  birth.  It  is  still 
growing — this  unconscious  of  mine — but  it  is  growing  more  and  more  out  into  the 
sunshine,  into  life — love.” 


Trigant  Burrow 


67 


transformed  into  healthy,  constructive  aims. 

We  should  say,  then,  that  the  clinical  pathology  of  the 
neuroses  consists  in  a principle  of  behaviour  that  is  based  on 
superstition,  and  that  its  morbid  anatomy  is  fear;  that  the 
exciting  cause  is  the  contagion  spread  by  false  educational 
methods  and  valuations,  the  basis  of  which  is  repression: 
that  in  virtue  of  this  repression,  the  affectivity  of  the  child 
which,  ever  urging  him  on  to  his  natural  quest  of  life,  nor- 
mally finds  its  outlet  in  those  expressions  of  spontaneous 
interest  afforded  in  social  contacts  and  in  creative  activity, 
is  thwarted  and  denied  through  the  enforcement  of  an 
arbitrary  program  of  anxious  morality  instigated  by  a super- 
stitious premonition  of  evil.  Given  the  above  conditions 
the  situation  may  in  my  view  be  summed  up  somewhat  as 
follows: — The  neurotic  is  the  individual  in  whom  the  sphere 
of  feeling  and  expression  has  not  come  into  its  own  by  reason 
of  an  early  inhibiting  fear.  The  unused  energies  however 
belonging  to  the  sphere  of  feeling  and  of  will,  have  been  by 
no  means  destroyed,  through  curtailment  and  denial,  but 
these  frustrated  affects  are  merely  converted  into  other 
forms  of  force,  for,  being  driven  back  upon  themselves,  we 
find  them  issuing  again  in  regressive  integrations,  expressed 
in  tendencies  toward  mere  egoistic  satisfaction  and  toward 
autoerotic  trends.  The  result  is  the  tendency  toward  the 
transformation  of  the  adult  libido  into  regressive  sexual 
affects.  But  “such  affects  are  utterly  incompatible  with 
the  ideals  of  the  contemporary  social  mind  as  presented  in 
the  sensitive  neurotic  patient,  and  his  suffering  and  inade- 
quacy are  in  my  interpretation  the  direct  expression  of  the 
unconscious  conflict  caused  by  this  inherent  discrepancy 
within  his  personality.  Such,  I believe,  is  the  mechanism 
underlying  the  fear  inhibition  which  is  the  essential  factor 
in  these  disturbed  psychic  states.”* 

I have  said  that  this  fear  inhibition  represents  a spurious 
morality — that  such  a morality  is  but  a fraudulent  sub- 
stitute for  the  organic  morality  (and  I mean  by  this  the 

*“Permutations  Within  the  Sphere  of  Consciousness,  or  The  Factor  of 
Repression  and  its  Influence  upon  Education.  ” Journal  Abnormal  Psychology, 
Aug.-Sept.,  1916.  Vol.  XI.  No.  3. 


68  The  Meaning  of  Psychoanalysis 

unity  and  truth)  which  underlies  life.*  I contend  that, 
repudiating  the  hobgoblin  of  anxious  moralities,  man’s 
security  and  comfort  lie  in  such  a view  of  life  and  its  obliga- 
tions as  only  a steadfast,  quiet,  intelligent  outlook  can  give 
him.  To  maintain  such  an  intelligent  vision  of  life  is  to  set 
honor  and  truth  above  temporary  hopes  and  petty  appre- 
hensions, and  the  more  I see  of  the  nervous  patient  who 
possesses  the  character  and  the  stability  to  accept  the  daily 
renunciations  demanded  by  psychoanalysis,  the  more  it 
becomes  clear  to  me  that  these  patients  are  unknowingly 
striving  with  the  best  that  is  inthem  toward  the  attainment 
of  some  such  surer,  saner  level  of  adaptation. 

It  is  to  aid  these  invalidated  men  and  women  to  escape 
the  deadlock  of  their  repression  by  helping  them  to  overcome 
their  resistances,  and,  unafraid,  to  place  themselves  at  one 
with  the  healthy,  forward-tending  processes  of  life  which 
constitutes  for  me  the  significance  of  the  problem  of  the 
neuroses,  and  which  represents  for  me  the  essential  meaning 
of  psychoanalysis. 

*For  ten  years  it  was  a puzzle  to  me  why  people  with  most  morality — that 
is  profession  of  good — wire  invariably  people  with  least  sense  of  honour.  The 
observation  clashed  painfully  with  deeply  revered  prepossessions  and  yet  it  pre- 
sented the  fidelity  of  law.  The  disparity  was  unfailing.  The  two  simply  see- 
sawed. But  having  examined  the  psychology  of  morality  and  having  seen  the 
pretense  that  is  inseparable  from  a fear-motivation,  the  consistency  of  this  varia- 
bility presented  no  further  problem. 


REVIEWS 

life  and  work  of  pestalozzi.  By  J.  A.  Green.  Warwick 
& York,  Baltimore.  393  pp.  Price  $1.40. 

This  book  incorporates  the  whole  of  the  author’s  earlier 
Pestalozzi’s  Educational  Ideas,  but  includes  much  new  material. 
The  treatment  is  divided  into  three  sections:  biographical;  exposi- 
tory; documentary.  The  subject  matter  is  well  worked  over, 
condensed  and  concretely  presented.  We  know  of  no  single 
volume  which  furnishes  such  a convenient  and  satisfactory  intro- 
duction to  the  life  and  work  of  Pestalozzi.  It  is  particularly 
useful  to  the  student  who  does  not  have  access  to  the  German 
sources,  because  of  the  well  selected  translations  in  the  documentary 
portion  of  the  text.  These  translations  include  The  Letter  on  the 
Education  of  Poor  Country  Children;  The  Pamphlet  of  1800;  The 
Prospectus  of  Miinchenbuchsee;  The  Report  to  Parents;  Con- 
temporary Accounts  of  the  Institutes  at  Burgdorf  & Yverdun; 
Two  Pestalozzian  Lessons.  The  Prospectus  and  the  Report  have 
not  until  now  appeared  in  English.  Extended  selections  from 
Pestalozzi’s  famous  diary,  one  of  the  first  systematic  efforts  in 
child  psychology,  are  included  in  the  biographical  section.  A 
descriptive  bibliography  of  Pestalozzi’s  Educational  Writings  is  a 
valuable  feature. 

Arnold  L.  Gesell. 

THE  PSYCHOLOGICAL  METHODS  OF  TESTING  INTELLIGENCE. 

By  William  Stern.  Translated  from  the  German  by  Guy  Mont- 
rose Whipple.  Warwick  & York,  Inc.,  Baltimore.  160  pp. 
Price  $1.75. 

Professor  Whipple  has  performed  a service  in  the  translation 
of  this  book,  which  is  a general  and  critical  survey  of  the  literature 
of  intelligence  testing.  The  treatment  while  not  exhaustive  is 
thorough.  The  style  is  adapted  for  lay  readers  as  well  as  profes- 
sional psychologists.  The  book  is  especially  to  be  recommended 
to  those  who  underestimate  the  value  of  the  Binet  method  of 
testing  mental  development,  and  who  have  no  conception  of  the 
considerable  amount  of  research  which  has  already  been  expended 
upon  this  method. 

Intelligence  is  defined  as  “general  mental  adaptability  to  new 
problems  and  conditions  of  life.”  Three  methods  of  testing 
intelligence  are  distinguished:  1.  The  method  of  separate  tests, 
which  originated  in  Germany.  2.  The  system  of  tests  with  age 
gradations,  which  arose  in  France.  3.  The  correlation  method, 
especially  developed  in  England. 

The  first  method  is  given  brief  treatment,  on  the  ground  that 
that  “the  single  test  tests  on  the  one  hand  more,  and  on  the  other 
hand  less  than  it  really  ought  to  test.” 

69 


70 


Review 


The  bulk  of  the  book  is  devoted  to  a critical  but  favorable 
discussion  of  the  Binet  method.  Results  from  the  use  of  the 
Binet  scale  by  investigators  in  different  countries  are  analytically 
compared.  Stern  concludes  that  the  scale  suffers  from  not  in- 
considerable errors  that  must  be  removed;  but  he  is  more  impressed 
with  the  “international  accordance,”  which  demonstrates  that 
“the  tests  do  actually  reach  and  discover  the  general  develop- 
mental conditions  of  intelligence.” 

The  final  section  of  the  book  deals  with  the  method  of  rank 
correlation,  which  Stern  considers  a promising  method,  because  it 
“gives  us  a numerical  device  for  discovering  that  combination  of 
tests  in  which  we  approach  most  nearly  to  perfect  compensation.” 
He  discusses  his  special  method  of  “amalgamated  ranks”  which 
he  believes  must  be  worked  out  into  a systematized  plan  of  pro- 
cedure as  has  already  been  done  with  the  method  of  age  levels. 
“Not  until  we  combine  both  these  ideas  can  we  hope  to  master 
the  whole  field  of  intelligence  testing.  The  system  of  levels  draws 
the  great  wave-lines  of  mental  development;  the  method  of  rank- 
ing sketches  the  finer  ripples  within  each  level.” 

Suggestions  are  made  regarding  the  revision  and  extension  of 
the  Binet  scale.  Some  of  these  are  embodied  in  Professor  L.  M. 
Terman’s  more  recent  work  on  The  Measurement  of  Intelligence, 
which  can  be  profitably  read  in  conjunction  with  Stern’s  volume. 

Arnold  L.  Gesell. 

the  influence  of  joy.  By  George  Van  Ness  Dearborn , Ph. 
D.,  M.  D.  Instructor  in  Psychology  and  in  Education , Sargent 
Normal  School,  Cambridge;  Psychologist  and  Physiologist  to  The 
Forsyth  Dental  Informal  for  Children,  Boston;  etc.  Boston:  Little, 
Brown  & Company,  1916.  Price  $1.00  net.  Pp.  X\  III  and  223. 

This  is  the  fourth  volume  of  The  Mind  and  Health  Series 
edited  by  H.  Addington  Bruce. 

The  work  is  divided  into  two  parts — called  by  the  author 
“the  power  of  joy”  and  “the  necessity  of  joy.” 

Dr.  Dearborn  has  undertaken  a truly  difficult  task  in  this 
work,  since  he  attempts  to  discuss  his  subject  from  the  scientific 
viewpoint  and  in  spite  of  this  to  present  his  subject  matter  in  a 
popular  fashion. 

He  is  probably  one  of  the  most  competent  men  in  this  country, 
if  not  indeed  the  best-fitted  man  amongst  us,  to  discuss  the 
question  of  the  influence  of  joy  on  mind  and  body. 

It  is  noteworthy  that  although  many  have  written  on  the 
effect  of  the  depressing  emotions  with  their  disintegrating  effects 
we  come  upon  few  who  write  scientifically  of  the  effects  of  the 
stimulating  and  synthesizing  emotions  of  man.  Dearborn  has 
devoted  much  thought  to  this  very  untilled  ground.  He  has 
given  us  an  interesting  and  up  to  date  exposition  of  a topic  which 
he  has  made  his  own. 


Review  1 71 

He  has  attacked  his  problem  to  a great  extent  from  the  phys- 
iological side. 

Owing  to  the  fact  that  this  subject  has  been  much  neglected 
in  normal  and  abnormal  psychology,  it  is  but  to  be  expected  that 
the  author  cannot  handle  it  with  the  positiveness,  clearness  and 
directness  that  one  can  employ  when  dealing  with  the  depressing 
emotions,  such  as  fear.  There  is,  as  a consequence,  a certain 
degree  of  vagueness  and  uncertainty  and  difficulty  of  expression 
apparent  throughout  the  discussion.  In  spite  of  this  handicap, 
the  reader  will  find  this  work  instructive,  entertaining,  and  stimu- 
lating. 

The  radiologists  at  present  find  much  difficulty  in  describing 
their  findings  because  of  paucity  of  any  generally  accepted  termi- 
nology. I believe  that  Dr.  Dearborn  has  had  to  contend  with  the 
same  problem.  Let  us  hope  that,  as  the  problem  with  which  he 
is  grappling  becomes  more  and  more  clearly  grasped,  the  ease  and 
directness  of  expression  will  progress  accordingly. 

Meyer  Solomon. 


studies  in  animal  behavior.  By  S.  J.  Holmes.  Richard 
G.  Badger,  1916,  Pages  266.  $2.50  net. 

In  “Studies  of  Animal  Behavior”  Holmes  has  offered  a number 
of  fascinating  glimpses  of  the  science  of  comparative  psychology. 
The  book  consists  of  several  essays  on  relatively  unrelated  topics 
of  behavior.  All  are  written  in  the  author’s  usual  clear  and 
interesting  style.  They  will  appeal  especially  to  the  general 
reader,  for  no  attempt  has  been  made  to  work  out  any  of  the 
suggested  problems  in  detail  or  to  marshal  varied  observational 
materials.  The  author  is  keen  in  his  appreciation  of  fundamental 
problems,  thoughtful  concerning  them,  and  extremely  lucid  in  his 
presentation  of  the  facts  which  bear  upon  them. 

Of  special  interest  to  students  of  animal  psychology  is  the 
introductory  chapter,  entitled  “Animal  psychology,  the  old  and 
the  new.”  This  historical  sketch  indicates  at  once  the  author’s 
wide  reading  and  his  keen  interest  in  the  varied  aspects  of  the  study 
of  mind.  For  the  first  time  in  the  history  of  the  science,  the  most 
significant  facts  of  its  development  have  been  brought  together. 
The  chapter  is  brief,  in  every  sense  readable,  and  may  be  com- 
mended to  the  specialist  quite  as  highly  as  to  his  pupils  or  to  the 
general  reader. 

In  succeeding  chapters,  the  author  discusses  such  interesting 
aspects  and  forms  of  behavior  as  the  tropisms,  the  behavior  of 
cells,  orientation,  behaviorffn  relation  to  form;  and  in  connection 
with  each  of  these  topics,  as  indeed  throughout  the  book,  he 
exhibits  with  surprising  effectiveness  the  significant  problems 
which  modern  investigators  are  attempcing  to  solve. 


7 2 


Review 


In  another  group  of  chapters,  various  aspects  of  the  general 
topic  “Instinct”  are  dealt  with.  Thus,  chapter  2 is  devoted  to 
a brief  consideration  of  the  evolution  of  parental  care;  chapter  XI, 
to  the  instinct  of  feigning  death:  chapter  12,  to  the  recognition  of 
sex;  chapter  13,  to  the  role  of  sex  in  the  evolution  of  mind. 

Holmes’s  reflections  concerning  the  beginnings  of  intelligence, 
the  relation  of  instinct  to  intelligence,  and  the  problem  of  learning, 
are  of  importance.  In  connection  with  learning,  he  points  out 
that  the  usual  pleasure-pain  hypothesis  does  not  adequately 
account  for  the  process  of  habit  formation.  He  proposes  the 
hypothesis  that  the  learning  process  is  conditioned  by  “congruity 
of  reactions.”  Agreeableness  or  disagreeableness  is  not  essential. 
When,  for  example,  a chick  pecks  at  a caterpillar,  either  a congruent 
or  a conflicting  response  may  be  initiated  by  the  gustatory  stimu- 
lus. To  quote  from  the  author  “When  one  part  of  the  structure 
concerned  is  excited,  it  tends  to  increase  the  tonus  of  the  associated 
parts,  and  thus  reinforce  the  original  response.”  This  hypothesis 
is  certainly  worthy  of  careful  consideration  and  should  suggest 
varied  lines  of  experimentation  by  means  of  which  the  process  of 
habit  formation  or  learning  may  be  more  completely  analyzed  and 
its  essential  factors  revealed. 

As  for  the  beginnings  of  intelligence,  the  author  suggests  that 
they  are  to  be  found  in  instinctive  reactions.  Indeed,  he  says  that 
the  “ adaptiveness  of  intelligence  is  based  upon  the  adaptiveness 
of  instinct.” 

In  the  concluding  chapter  of  the  volume,  entitled  “The 
mind  of  a monkey,”  the  author  has  described  in  most  interesting 
fashion  some  observations  which  he  made  on  a specimen  of  bonnet 
monkey.  This  chapter  well  indicates  his  interest  in  every  aspect 
of  behavior  and  his  ability  to  popularize. 

Although  in  no  sense  a contribution  to  the  sj’stematic  scientific 
literature  of  behavior,  Holmes’s  volume  is  important,  for  few 
specialists  in  biology  have  such  great  ability  to  present  their 
problems  and  results  in  interesting  guise  as  Holmes  has  exhibited 
in  this  series  of  essays  and  in  his  earlier  volume  entitled  “The 
Evolution  of  animal  intelligence.” 

Robert  M.  1 erkes. 
BOOKS  RECEIVED 

The  Significance  of  Psychoanalysis  for  the  Mental  Sciences. 
Rank  & Sachs.  Trans,  by  Chas.  R.  Payne.  Ner.  and  Men.  Dis. 
Mon.  Series  23 — Pp.  V and  127.  $1.50. 

The  Kingdom  of  the  Mind  by  James  Mortimer  Iveniston.  G.  P. 
Putnam’s  Sons.  Pp.  X and  245.  $1.25  net. 

The  Belief  in  God  and  Immortality  by  Jas.  H.  Leuba.  Sher- 
man, French  & Co.,  Boston.  Pp.  XVII  and  340.  $2.50  net. 


THE  JOURNAL  OF 
ABNORMAL  PSYCHOLOGY 

JUNE,  1917 

SKETCH  FOR  A STUDY  OF  NEW  ENGLAND 
CHARACTER 

BY  JAMES  J.  PUTNAM,  M.  D. 

DURING  portions  of  the  past  few  years,  I have  had 
the  opportunity  to  investigate  as  freely  as  I wished 
into  the  life-history  of  a lady  who  came  to  me 
originally  as  a patient,  but  became,  later,  a friendly 
and  eager  fellow-worker.  I hope,  eventually,  to  publish  at 
some  length  extracts  from  the  rich  store  of  material  which 
she  has  written  out,  at  my  suggestion,  and  which  possesses 
the  kind  of  interest  and  power  of  conviction  such  as  belongs 
peculiarly  to  every  genuine  account  of  individual  experiences 
of  an  intimate  sort. 

The  story  as  here  given  seems  to  me  important,  not  be- 
cause of  dramatic  features, — which,  in  fact,  it  does  not 
possess, — but  on  the  following  accounts:  (1)  It  illustrates 

conflicts  which  present  themselves  to  many  persons.  (2) 
It  throws  light  on  certain  undesirable  effects  of  a strict, 
“old-fashioned”  religious  training,  and  on  the  symptoma- 
tology of  the  so-called  “New  England  conscience”  (which 
has  a very  morbid  side).  (3)  Finally,  what  is  of  prime 
importance,  it  brings  into  strong  relief  certain  common  and 
typical  influences  which  tend  to  prevent  the  relationship 
between  children  and  their  parents  from  being  a source  of 
unadulterated  benefit  to  both,  as  it  should  be,  but,  on  the 
contrary,  to  make  it,  in  some  respects,  a source  of  tempta- 
tions and  conflicts  of  which  the  best  that  can  be  said  is  that 
they  are  not  without  their  compensations. 

This  lady  came  to  me  for  the  first  time  about  five  years 
ago,  when  forty-nine  years  old,  “not  as  a very  sick  person,” 
■ — though  in  fact  she  had  been  a good  deal  of  an  invalid  since 
birth,-— “but  in  the  hope  of  learning  how  to  adjust  herself 
to  life.”  And  so  satisfactory  has  been  her  progress  along 
these  lines,  to  such  a degree  has  she  exchanged  her  former 
sense  of  inhibition  and  incompleteness  for  one  of  freedom 

Copyright  1917  by  Richard  G.  Badger.  All  Rights  Reserved. 

73 


74  Sketch  for  a Study  of  New  England  Character 

and  emancipation,  that  the  spectacle  of  her  improvement  has 
been,  for  me,  a source  of  satisfaction  and  encouragement. 

At  her  first  visit  she  said  that  she  felt  nervous,  shy, 
apprehensive,  and  lacking  in  self-confidence,  conscious  of 
intelligence  but  unable  to  use  it  to  good  purpose.  When 
called  upon  to  meet  people  in  a social  way  she  often  hesitated 
in  her  speech,  and  then  her  voice  would  grow  harsh  and 
loud  and  her  hands  tremulous,  sometimes  to  a high  degree. 
She  suffered  much  from  periodical  headaches,  not  distinctly 
migrainoid  in  type,  and,  in  addition,  from  a dull  head- 
pressure  which  had  grown  to  be  habitual.  I will  anticipate 
the  further  history  of  this  symptom  by  saying  that  it  proved 
to  be  distinctly  of  neurotic  origin.  It  seemed  to  her,  as  the 
analysis  proceeded,  that  the  headaches  were  the  expression 
of  a sort  of  helpless  rage  with  reference  to  her  troubles,  and 
they  grew  less  and  eventually  ceased  as  her  conflicts  became 
resolved.  It  might  have  been  thought  that  they  were  due 
to  eye-strain,  from  which  she  suffered  seriously  until  about 
thirteen  years  of  age.  But  in  fact,  the  headaches  did  not 
come  on  until  she  was  twenty-seven  years  old, — that  is, 
long  after  the  correction  of  her  error  of  refraction  had  been 
made  by  glasses;  nor  was  any  further  treatment  of  this  sort 
operative  in  bringing  her  relief.  It  is  also  of  interest  that 
these  headaches  came,  she  said,  at  first  at  nine  days’  in- 
tervals, then  at  intervals  of  six,  and  finally  of  three  days. 
I shall  take  advantage  of  some  future  occasion  to  point  out 
that  the  number  three  and  its  multiples  played  an  important 
part  in  her  unconscious  thoughts,  as  indicated  by  her  dreams. 

Her  defective  eyesight,  if  not  mainly  responsible  for  her 
headaches,  was  of  much  significance  on  other  grounds.  It 
was  not  the  fashion  in  that  day  to  spend  much  time  in  study- 
ing children’s  eyesight;  and  the  fact  that  the  duty  of  self- 
subjection and  of  overriding  difficulty  by  effort  loomed  up 
as  paramount  in  her  parents’  eyes,  turned  aside  their  atten- 
tion— devoted  though  they  wrere,  after  their  own  fashion — 
from  the  need  of  other  sorts  of  treatment.  Throughout 
her  childhood,  before  the  corrective  glasses  were  applied, 
her  eyesight  was  so  poor  that  she  often  stumbled  as  she 
walked,  and  to  read  books  or  music,  or  problems  o‘n  the 
blackboard,  or  to  do  fine  housework,  involved  a painful 


James  J.  Putnam 


75 


strain.  This  condition,  combined  with  her  deficiency  in 
endurance,  led  her  almost  to  abandon  active  games  and  to 
lose  the  training  in  power  of  adjustment  that  goes  with 
them,  and  brought  her  much  scolding  for  carelessness  and 
stupidity, — through  which  a native  tendency  to  self-dis- 
paragement became  intensified. 

It  was  the  study  of  the  direct  and  indirect  effects  of 
special  organic  weaknesses,  such  as  eve-strain,  that  induced 
Alfred  Adler  of  Vienna  to  regard  these  local  weaknesses  as 
■the  point  of  departure  for  his  theory  of  character-formation. (1) 
Every  organic  (and  so,  functional)  defect  serves  as  a direct 
handicap,  on  the  one  hand,  and  leads,  on  the  other  hand,  to 
instinctive  compensatory  efforts  (especially  on  the  part  of 
the  nervous  system)  which  may  induce  a high  degree  of  real 
compensation,  and,  indeed,  over-compensation,  or  to  com- 
plex reactions  of  substitution.  Such  influences  were  un- 
doubtedly present  in  this  case,  not  only  as  they  relate  to  the 
defective  eyesight,  but  also,  and  probably  still  more,  with 
reference  to  ill-health  from  other  causes.  For  this  patient 
was  a seven  months’  child,  and  remained  for  a long  time 
poorly  nourished,  growing  a little  stronger  after  some  years, 
only  to  fall  sick  again  in  adolescence.  Furthermore  (for 
special  reasons  which  cannot  be  referred  to  here),  her  very 
advent  was  unwelcome,  and  both  her  weakness  and  her  sex 
were  sources  of  regret  and  mortification  to  her  mother;  and 
these  facts  increased  the  necessity  for  special  compromises, 
adaptations,  and  compensations  on  her  part,  of  the  true 
nature  of  which  she  has  gradually  became  aware. 

The  facts  given  by  my  patient  at  the  first  recital  of  he 
troubles  might  have  seemed  suggestive  of  nothing  m or 
than  one  of  the  common  forms  of  nervous  invalidism,  with 
its  bottomless  well  of  minor  sufferings,  for  which  the  term 
“neurasthenia”  is  still,  by  many  persons, looked  upon  as 
competent  to  cover,  though  in  fact  it  tells  nothing  of  the 
mechanisms  involved.  Little  by  little,  however,  more  light 
was  thrown  upon  the  sources  of  her  troubles. 

1The  theory  of  compensation  here  referred  to  has  long  been  recognized  as  a 
very  important  one,  and  Adler’s  contributions  to  it  are  of  real  value.  I do  not 
believe,  however,  that  it  has  anything  like  the  exclusive,  thorough-going  signifi- 
cance which  he  attributes  to  it.  Pain  and  evil  are,  fortunately,  not  our  only 
teachers;  nor  is  adjustment  to  a given  universe  our  only  goal. 


76  Sketch  for  a Study  of  New  England  Character 

Starting  life  as  a weakly  child,  and  with  few  companions 
outside  of  her  own  family,  she  became  a somewhat  self- 
centered  girl,  but  an  ardent  and— as  the  phrase  runs — an 
“over-conscientious”  student,  and  showed  evidence  of  a fine 
mind. 

At  the  period  of  her  first  visit  to  me  she  was  living  alone, 
her  mother  having  died  some  months  before,  and  likewise 
(several  years  earlier),  the  older  of  her  two  brothers,  to  whom 
she  had  been  passionately  devoted. 

Further  questioning  as  to  her  symptoms  showed  that 
beneath  a non-committal  manner  she  carried  a highly  over- 
wrought, emotional  sensitiveness,  through  which  her  long- 
ings for  recognition  had  become  converted  into  pain,  in 
which  form  she  found  a certain  (poor  and  incomplete)  grati- 
fication. As  a part  of  this  tendency  she  had  become  very 
unpleasantly  acute  to  sounds  and  odors,  and  also  to  the 
slightest  interruption  to  whatever  occupation  she  might  be 
engaged  upon,  even  through  calls  made  by  good  friends. 
In  fact,  social  intercourse  was  longed  for;  yet  so  little  did 
she  understand  her  own  needs  and  the  means  of  meeting 
them  that  the  most  trifling  demand  for  sacrifices  in  the 
practical  interest  of  a wider  social  life  aroused  almost  a 
sense  of  resentment  in  her  mind.  Every  trivial  noise,  even 
the  rustling  of  a newspaper,  she  says,  would  bring  a frown  of 
annoyance  to  her  forehead.  The  odors  which  she  disliked 
often  had  reference  to  dishes  which  her  mother  liked,  and — 
inspired  by  a certain  hostility  to  herself,  as  she  half-fancied — 
insisted  on  having  cooked. 

“To-day,”  she  writes,  “I  think  that  my  objections  were 
an  infantile  mode  of  expressing  opposition  to  my  mother. 
I wanted  to  be  mistress  of  my  own  home  (i.  e.,  of  a home  of 
my  own)  ”. 

As  for  visitors,  her  double  feelings  made  her  adopt  a 
manner  toward  them  which  said  “Goodbye,”  in  spite  of  the 
fact  that  she  was  inwardly  bewailing  her  loneliness,  longing 
for  companionship  and  love,  and  desperate  to  break  through 
the  isolation  in  which  she  felt  herself.  She  wTould  have  been 
ready  enough,  at  any  moment,  to  call  herself  “selfish,” 
“morbid,”  “egoistic,”  but  to  do  so  would  have  been  of  no 
avail  and  unjust  to  her  best  self. 


James  J.  Putnam 


77 


No  person’s  character  is  wholly  unified,  and  the 
character  of  every  one  may  conveniently  be  studied  under 
four  heads,  as  representing  four  tendencies  that  are  closely 
interwoven,  (i)  Every  person  is  striving  in  some  measure, 
even  though  helplessly,  to  express  the  best  that  is  in  him, 
and  thus  to  fulfil  his  social  obligations.  (2)  Every  one  is 
under  an  intense  pressure  to  conform  in  thought  and  conduct 
to  standards  virtually  set  by  the  community.  This  tendency 
might  be  described  as  an  instinctive  attempt  at  protective 
coloration.  (3)  Every  one  has  in  him  a more  or  less  strong 
leaning  to  revert,  in  action,  thought  and  feeling,  to  the  level 
of  standards  which  express  that  quality  in  him  which  might 
be  described,  according  to  circumstances,  as  immature, 
infantile,  pleasure-seeking,  carnal,  or  personal  in  an  exclusive 
sense.  Finally  (4),  inasmuch  as  there  is  no  difference  except 
in  degree  between  the  nervous  invalid  and  the  so-called 
normal  person,  it  would  be  fair  to  say  that  every  one  carries 
symptoms  which  have  the  following  two  meanings:  in  the 
first  place,  they  indicate  that  he  is  seeking  to  escape  from  the 
handicaps  just  referred  to,  more  or  less  as  the  persons  des- 
cribed by  Dante  are  striving  to  climb  up  the  Hill  of  Purga- 
tory; in  the  next  place  they  indicate  also  that  he  is  still  under 
the  sway  of  the  passionate  longings  which  he  feels  to  be 
incompatible  with  his  best  social  tendency. 

This  patient  had  the  desires  indicated  under  the  first 
of  these  headings,  in  considerable  degree.  But  mingled  with 
them  there  were  strong  longings  of  the  third  order, — for  the 
sake  of  gratifying  which  she  learned  to  use  her  imagination  in 
a way  that  was  unsatisfactory,  and  unproductive  of  per- 
manently good  results.  Excitement,  symbolizing  her  de- 
sires, came  to  play  too  large  a part  in  her  fancies  and  her 
dreams,  and  she  learned  too  much  to  seek  for  gratification 
in  the  pain  of  her  symptoms. 

One  tendency  of  this  lady,  which  made  little  show  as  a 
symptom  on  the  surface,  yet  which  in  its  working  out  was 
perhaps  the  worst  one  of  all,  was  that  she  seemed  impelled 
by  some  cross-purpose  impulse  to  do  or  say,  at  critical 
moments,  the  very  thing  that  defeated  her  own  object. 
This  tendency  is  familiar  enough  to  every  one,  but  in  her 
not  only  was  it  so  strong  that  she  lost  some  excellent  chances 


78  Sketch  for  a Study  of  New  England  Character 

for  remunerative  and  pleasant  work  and  for  forming  valu- 
able friendships,  but  it  has  a psychological  interest  which  I 
will  speak  of  later.  I was  reminded,  in  thinking  on  this 
symptom,  of  the  inability  of  Sisyphus  to  drink  of  the  re- 
freshing waters  that  kept  rising  to  his  lips.  The  inhibitions 
of  King  Saul  may  be  recalled,  in  further  illustration. 

Besides  these  various  traits,  this  patient  wras  subject  to 
compulsions  of  familiar  sorts,  affecting  both  her  thoughts 
and  acts. 

“When  we  sign  our  names  to  letters,”  she  writes, 
“that  is  commonly  the  end.  But  to  me  it  was  not  the 
end.  I wrote  them  over  and  over  again,  even  when  I 
was  certain.  When  mailing  them  I would  hesitate  a 
long  time,  standing  before  the  letter-box.  Finally  I 
would  put  them  in,  and  immediately  wish  to  snatch  them 
out.  Hours  afterwards  I would  picture  myself  pulling 
them  out  of  the  box.” 

In  a similar  fashion  she  required  repeated  assurances 
that  she  had  closed  a bureau  drawer  or  locked  a door. 

Here  we  see  evidence  enough  of  doubt  and  fear  about 
her  ability  to  follow  a consistent  aim  in  life,  and  the  frantic 
efforts  to  follow  at  once  two  incompatible  courses,  two 
divergent  paths,  or,  again,  to  repress  and  to  lock  her  mind 
against  instinctive  longings,  which,  had  she  understood  them 
better,  she  might  have  faced  and  made  to  jibe  with  reason 
and  her  best  desires.  Instead  of  this,  they  stood  as  signs 
of  what  might  be  called  the  tragedy  of  a baffled  life,  which 
came  near  to  being  balked  and  wrecked. 

Discontent,  and  a strong  tendency  to  brood  painfully 
over  the  past,  soon  led,  as  she  records,  to  an  exhaustion 
and  a series  of  petulant  changes  of  mood  virtually  toward 
herself. 

“Other  people  appeared  to  be  living  happy  lives 
. . . My  present  disappointment  "was  the  result  of 

obedience  to  parents,  faithfulness  to  duty,  utter  elimina- 
tion of  self.  It  did  not  pay  to  be  so  self-sacrificing. 

If  I had  my  life  to  live  over  again  I would  be  reckless 


James  J.  Putnam 


79 


in  self-gratification  . . . Before  I knew  it  I be- 

came exacting  toward  myself  and  toward  every  one 
in  the  house.  Fear  pursued  me  every  moment  of  the 
day,  fear  lest  I swerve  from  the  straight  path  of  duty.” 

She  had  been  very  fond  of  music  and  longed  for  a 
musical  education,  but  this  her  father  would  not  sanction  and 
it  was  characteristic  that  she  reacted  in  Calvinistic  fashion 
to  her  disappointment  and  became  a “wet-blanket  to  en- 
joyment.” ■ 

“My  Puritan  training  demanded  quiet.  The  piano 
must  not  be  used  except  for  appropriate  music.  There 
must  be  no  teas,  no  spreads,  no  afternoon  callers.  Except 
for  the  singing  of  hymns  morning  and  night,  the  house  had 
to  be  as  quiet  as  the  grave.  Qualms  of  conscience  accom- 
panied the  reading  of  the  psalms.” 

Nevertheless, 

“My  heart  yearned  mightily  for  the  very  pleasures 
that  I condemned.” 

Another  set  of  symptoms  clustered  around  the  fact 
that  from  her  earliest  years  she  entertained  longings  for 
motherhood,  which  were  far  too  intense  and  far  too  little 
understood.  Even  a superficial  analysis  of  her  dreams  makes 
this  abundantly  evident.  In  fact,  the  very  first  dream 
after  she  presented  herself  for  treatment,  which  is  recognized 
as  being  of  special  significance,  showed  her  in  my  office  in 
company  with  her  mother,  and  as  if  identifying  herself  with 
her,  a circumstance  which  her  experience  and  associations 
showed  clearly  to  have  that  significance.  She  felt  that  in 
this  dream  she  was  giving  away  the  secret  of  her  life — the 
longing  to  be  herself  a mother.  “Furthermore,”  she  says, 
“as  a very  small  child,  between  three  and  four  years  of  age, 
I loved  other  children  dearly.  From  the  time  I was  nine 
until  I was  twelve  I had  the  care  of  my  youngest  brother.  ” 
This  experience  was  important  and  perhaps,  in  part,  con- 
trolling. She  was  extremely  devoted  to  this  younger 
brother,  and  on  that  ground  enjoyed  the  care  of  him. 


80  Sketch  of  a Study  of  New  England  Character 

Nevertheless,  she  had  often  to  sit  by  his  cradle  while  friends 
were  playing  outside,  and  the  half-repressed  longing  to  be 
with  them  became  strong  within  her  mind.  After  she  grew 
older  and  had  graduated  from  college,  she  developed  almost 
a hatred  for  the  girls  who  boarded  with  her  mother,  while  at 
the  same  time  envying  them  their  joys.  The  children  also 
became  objects  of  hostility  to  her.  They  were  “disturbers 
of  the  peace.” 

I have  said  that  her  arrival  in  the  world  was  an  un- 
welcome event  to  her  mother,  but  certain  further  details 
about  her  early  childhood  call  also  for  mention.  Her 
mother — a person  of  fine  traits  and  great  power  of  self- 
denial,  but  herself  a prey  to  conflicts  and  dissatisfied  with 
her  lot  as  she  found  it — had  married  without  the  knowledge 
and  consent  of  her  family,  and  had  kept  the  marriage  secret, 
presumably  because  she  was  a teacher  and  could  not  afford 
to  give  up  her  place. 

My  patient  was  prematurely  born,  weighed  only  two 
and  one-half  pounds  at  birth,  and  was  an  unpleasing  sight. 
The  attending  physician  was  angry  and  gave  the  mother  a 
scolding  which  she  resented  as  unjust,  and  this  increased  her 
inclination  “to  hate  the  innocent  cause”  of  the  painful 
situation.  Only  her  father  was  pleased,  and  his  joy  was  not 
unmixed  with  pain.  From  then  on,  however,  he  took  his 
child  under  his  special  charge  and  was  absolutely  devoted. 
For  three  months  every  one  despaired  of  the  child’s  life. 
When  she  was  a young  girl  her  father  wrote  her  a note  of 
intense  solicitude,  in  which  he  described  in  strong  terms  the 
depth  of  interest  with  which  he  regarded  her  career,  tier 
mother  was  so  unhappy  about  the  whole  situation  that  it 
was  “a  distress  to  have  me  near,”  the  patient  writes;  “it 
was  a relief  to  her  whenever  I went  away  from  home.  ” 
Again: 


“ I did  not  know  why  my  mother  did  not  love  me. 
I knew  simply  that  she  did  not.  I made  pathetic  efforts 
to  gain  her  love, — all  without  success.  I think  father 
gave  me  an  extra  measure  of  love  because  of  mother’s 
refusal.  Naturally  I turned  more  and  more  toward 
father.  His  affection  had  in  it  something  of  passion.” 


James  J.  Putnam 


81 


Her  mother  on  the  contrary  objected  to  tokens  of 
affection,  and  “the  fact  that  she  repulsed  me  made  me  all 
the  more  ardent  in  my  demonstration  toward  other  people.” 

Her  father  then,  became  the  object  of  her  admiration 
and  was  her  constant  companion  so  far  as  his  business,  which 
called  him  much  away  from  home,  allowed.  As  time  went 
on  this  (reciprocated)  passion  for  her  father  grew  steadily 
more  strong  and  more  engrossing. 

The  evidence  is  overwhelming,  though  I can  do  no  more 
than  hint  at  it  in  this  place,  that  her  longing  for  closer 
intimacy,  or  identification,  with  him  was  as  strong  as  it 
well  could  be,  and  knew,  in  fact,  no  limits.  He  once  said 
to  her  that  if  he  were  not  married  to  her  mother  he  would 
like  to  take  her  for  his  wife;  and  her  mother,  in  her  turn, 
exclaimed,  on  one  occasion,  “I  believe  you  would  marry 
your  father,  if  you  could.”  As  a child  of  eleven  she  adopted 
for  herself,  in  secrecy,  a middle  name  which  began  with  the 
same  letter  with  her  father’s  middle  name,  in  order  that 
their  initials  might  be  identical.  On  one  occasion,  when  they 
were  all  three  on  a journey,  which  involved  a trip  by  water, 
when  her  father  and  mother  were  about  to  enter  their  state- 
room for  the  night  she  put  out  her  hand,  under  a strong  but 
momentary  impulse,  to  hold  her  mother  back,  and  incurred 
in  so  doing  the  latter’s  great  displeasure. 

At  one  period  in  her  life — when  she  was  seventeen  or 
eighteen  years  of  age — her  father  distinctly  held  her  back, 
by  the  expression  of  a strong  wish,  from  the  chance  of  finding 
a real  lover.  He  did  this  because  he  wished  her  to  devote 
her  whole  time  to  her  studies.  Whether  this  was  desirable 
or  not,  these  are  possibilities  with  which  it  is  dangerous  to 
tamper.  His  wish  at  that  time  was  law,  and  although  it  is 
true  that  she  did  later  find  her  affections  more  or  less  strongly 
involved,  yet  there  is  no  doubt  that  the  magic  of  his  per- 
sonality held  her  with  far  too  strong  a grip.  When  he  was 
growing  infirm,  he  expressed  a hope,  at  last,  that  she  would 
marry.  But  then  it  was  too  late,  and  when  she  caught  his 
meaning  she  felt,  with  intense  grief,  that  he  had  deserted  her. 
He  had  been,  as  she  said,  her  God;  and  when  finally  he  died 
she  felt  as  if  God  had  literally  forsaken  her. 

I speak  of  these  details,  which  might  easily  be  multi- 


82  Sketch  of  a Study  of  Nezv  England  Character, 

plied,  for  the  reason  that  parents  often  fail  to  realize  that 
their  children  belong  not  to  them,  but  to  the  world,  and 
that  their  place  in  the  world  must  be  found  largely  through 
their  own  unaided  efforts.  The  love  of  the  parent  for  the 
child,  as  of  the  child  for  the  parent,  begins  with  a strong 
longing  which  is  essentially  in  them , rather  than  for  its 
object;  and  it  may  happen  that  much  thought  and  the 
cultivation  of  a willingness  to  make  great  sacrifices  is  re- 
quired before  the  passionate  devotion  takes  on  at  least  its 
best  form. 

Another  unfortunate  outcome  of  such  an  intense  devo- 
tion between  the  parent  and  child  of  opposite  sexes  is  that 
it  very  often  interferes  seriously  with  the  feeling  of  the 
child  for  the  parent  of  the  same  sex.  Every  person,  and 
especially  every  child,  intensifies  his  feelings  through  the 
principle  of  contrast.  How  often  does  one  hear  it  said, 
when  an  opinion,  favorable  or  unfavorable,  is  expressed — let 
us  say,  of  one  of  two  brothers,  or  two  sisters, — “Yes,  this 
is  true  of  him  (or  her),  but  not  nearly  so  true  as  it  is  of  the 
other  of  the  two.”  Such  was  eminently  the  case  with  my 
patient.  Her  mother  was  conscientious  and  devoted,  but 
their  temperaments  were  not  harmonious,  and  the  gap 
between  them,  although  it  was  never  positively  recognized 
even  as  a gap,  became  a chasm  in  the  patient’s  inner  thoughts 
through  the  intensity  of  her  devotion  to  her  father. 

This  may  be  a suitable  place  for  calling  attention  to  a 
principle  which,  in  my  judgment,  is  of  great  importance. 
It  often  offends  the  mind  of  persons  not  accustomed  to  ade- 
quately broad  thinking  on  these  subjects,  to  hear  it  said 
that  a child  takes  its  father  as  a God,  while  at  the  same  time 
it  is  often  pointed  out  that  the  love  for  the  father  is  largely 
selfish  in  its  nature,  an  intensification  of  the  child’s  love  for 
itself.  On  the  other  hand,  psychologists  of  certain  sorts 
are  only  too  fond  of  pointing  out  that  there  is  nothing  to 
the  conception  of  God  but  what  is  derived  from  the  con- 
templation of  the  father’s  virtues,  and  a longing  to  make 
them  one’s  own. 

In  similar  fashion,  it  offends  the  mind  to  have  it  pointed 
out  that  the  ceremonials  of  religion  are  but  a modified  form 
Gf  the  neurotic  ceremonials  of  expiation  and  propitiation 


James  J.  Putnam 


83 


which  the  guilty  feeling  person  adopts  for  his  own  relief;  or 
that  the  symbols  of  religious  worship  are  identical  with  sym- 
bols instinctively  selected,  usually  in  pagan  days,  with  far 
different  and  apparently  opposed  meaning.  What  is  said 
later  in  this  paper  about  the  significance  of  the  breeze, 
wind  and  spirit  involves  the  same  principles  in  another  form. 

But  it  is  time  that  our  views  should  become  broader  on 
these  matters,  and  this  broadening  is  needed  by  the  ad- 
vocates both  of  what  might  be  called  the  leaders  of  spiritual 
thought,  on  the  one  hand,  and  those,  on  the  other  hand, 
who  can  see  in  the  spiritual  life  nothing  but  an  outgrowth 
of  material  forces  of  the  universe,  conceived  of  in  a narrow 
sense.  What  is  needed  is  that  both  sets  of  views  should  be 
modified  in  such  a way  that  it  should  be  seen  that  the 
spiritual  idea  can  gain  body  and  richness  through  the  con- 
tribution of  sense  images  and  feelings  without  losing  any- 
thing of  its  own  value.  If  our  thoughts  are  in  the  skies, 
our  feet  must  and  should  be  on  the  earth,  and  there  is  nothing 
belittling  in  the  fact  that  our  instincts  are,  in  a sense,  the 
offspring  of  the  forces  of  nature,  the  instincts  of  the  animal, 
and  of  the  primitive  savage,  as  well  as — preeminently — of 
our  own  childhood. 

It  does  not  materially  change  the  nature  of  our  obliga- 
tions in  this  respect  that  a given  person  accentuates  too  much 
one  or  another  step  on  this  road  from  the  “natural”  toward 
the  spiritual,  and  makes  a stopping-place,  at  which  to 
linger  with  undue  enjoyment,  of  what  should  be  a place  of 
passage.  The  person  who  makes  this  error  is  sure  to  suffer 
therefor.  But  in  some  measure  and  in  some  respect  we  all 
do  it,  and  each  one  deserves  the  understanding  sympathy 
of  the  rest.  In  fact,  as  I believe,  as  there  is  no  person  who 
does  not  cling  unduly  to  some  infantile  trait  or  self-indul- 
gence, so  there  is  no  one  whose  life  is  not  animated  in  some 
measure  by  the  slender  but  irresistible  influence  which  sets 
toward  a grouping  of  his  powers  and  forces  such  as  is  for  him 
“the  best.”  And  this  connects  each  person  with  his  own 
ideal  self,  or,  better,  demonstrates  the  existence  of  this  ideal 
self  in  him. 

Had  the  feeling  for  her  father  retained  a purely  spiritual 
form,  and  had  she  been  able  to  play  a satisfactory  part  in 


84  Sketch  for  a Study  of  New  England  Character 

the  so-called  real  world,  this  patient’s  father-love  might  have 
been  well  and  good.  In  fact,  it  led  to  fanciful  longings  which 
made  it  hard  for  her  to  take  her  own  place  amongst  her 
natural  companions. 

I have  said  that  the  patient’s  early  and  later  religious 
training  played  an  extremely  significant  part  among  the 
influences  that  formed  her  temperament,  and  will  now  go 
into  this  subject  at  somewhat  greater  length.  Her  memory 
on  this  point  reaches  back  to  the  time  when  she  was  four 
years  old,  and  she  recalls  that  even  then  she  had  begun  to 
take  part  in  the  daily  readings  from  the  Bible  and  in  learning 
passages  by  heart,  and  had  come  under  the  influence  of 
what  she  always  referred  to  as  “the  little  red  book,”  a 
narrow,  bigoted  publication  by  the  American  Tract  Society, 
on  the  basis  of  which  she  was  expected  to  regulate  her  life. 
Unfortunately  the  common  pleasures  of  childhood  were,  to 
say  the  least,  very  imperfectly  represented,  and  but  little 
chance  was  afforded  for  play,  which  to  the  normal  child  is  as 
the  breath  of  life. 

“Both  my  parents  recognized  that  children  must 
play;  nevertheless,  the  time  taken  for  it  was  rather 
considered  wasted.  Sunday  School  teachers  impressed 
upon  all  the  children  the  fact  that  they  must  work, 
and  the  hymn,  ‘Work,  for  the  night  is  coming,’  was 
one  of  those  that  incited  us  to  action  of  a helpful  order 
. . Even  our  pleasures  were  of  a serious  nature.” 

And  again, 

“Something  was  decidedly  wrong  with  a child  if 
he  did  not  think  it  was  his  chief  joy  to  love  God  and 
obey  Him.  This  included  love  and  obedience  to 
parents.  The  obedience  exacted  by  the  church  and  the 
home  was  of  such  an  absolute  character  as  to  very  near- 
ly exclude  individual  choice.  Perfect  obedience  was  a 
real  hindrance  to  full  self-expression.  My  mother  once 
said,  ‘Your  Aunt  Mary  has  disciplined  Richard  and 
given  him  such  a rigid  training  that  she  does  not  know 
the  real  nature  of  the  boy.’  I know  this  same  thing 
was  true  of  myself.” 


James  J . Putnam 


85 


And  again, 

“Not  only  was  play  discouraged  to  a large  extent, 
but  we  were  given  the  impression  that  it  was  a sin  to 
waste  time,  that  we  were  accountable  to  God  for  every 
moment  and  we  must  make  every  moment  count  to- 
wards some  good  end.  This  conviction  was  like  a lash 
driving  us  to  duty.  There  were  moments  when  I felt 
myself  hating  the  words  ‘duty’  and  ‘discipline.’  I 
would  almost  have  been  willing  to  die  to  escape  them. 

“As  I expected  a voice  from  Heaven,  so  in  answer 
to  prayer  Ilooked  for  gifts  from  Heaven.  A father  will 
hold  up  a toy  in  front  of  an  infant,  then  when  the  infant 
reaches  for  it  will  drop  it  into  his  lap.  In  the  same  way 
my  imagination  pictured  God  as  bestowing  gifts  upon 
me,  and  I seemed  to  think  they  would  come  without 
any  effort  on  my  part  save  the  asking.  This  was  an 
unfortunate  idea  and  acted  also  as  an  inhibition.  Why 
work  for  something  which  I could  obtain  without  work? 
I am  certain  many  an  adult  Christian  of  those  days 
behaved  as  if  he  believed  the  same  thing. 

“The  body  was  considered  as  a hindrance  to 
spirituality.  We  were  encouraged  to  despise  the  body 
and  to  think  more  about  the  well-being  of  the  soul.  It 
seemed  as  if  the  body  were  something  which  prevented 
the  life  of  the  soul  instead  of  representing  a channel 
for  energy  to  flow  out  to  the  immediate  environment. 
One  reason  why  the  body  was  despised  was  because 
it  caused  the  soul  to  sin.  If  a person  longed  to  dance, 
that  was  a pleasure  of  the  body  and  must  be  denied 
because  the  heavenward  progress  of  the  soul  would  be 
impeded.  When  I was  about  seven  years  of  age,  I 
begged  my  parents  to  let  me  have  dancing  lessons.  It 
could  not  be  allowed.  Only  very  worldly  people  would 
indulge  in  dancing.  When  it  came  to  singing,  there 
was  not  much  difference  made.  Children  might  sing 
school  songs  and  Sunday  School  songs  and  hymns. 
Later  one  could  enter  a church-choir  or,  perhaps,  join 
a chorus  where  oratorios  were  sung.  To  be  a concert 
singer  or  to  think  of  studying  for  opera  was  like  going  to 


86  Sketch  for  a Study  of  Nezv  England  Character 

perdition.  Going  to  the  theatre  and  playing  cards  were 
sins  of  a high  order. 

“Aside  from  the  books  used  in  our  school  work,  we 
were  permitted  to  read  only  a very  few  others — ‘Pil- 
grim’s Progress,’  ‘Uncle  Tom’s  Cabin,’  books  of  travel, 
and  (as  we  grew  older)  Milton’s  ‘Paradise  Lost,’  and 
Shakespeare’s  plays.  After  a while  the  Sunday  School 
had  a library;  but  books  received  from  there  were  very 
flat  and  uninteresting,  of  the  ‘goody-goody’  sort.” 

This  religious  training  created  an  atmosphere  which 
was  indeed  stimulating  to  her  conscience,  and  inspiring  to 
her  literary  instincts,  since  she  learned  to  know  the  Bible 
through  and  through;  but  in  several  respects  it  had  a dis- 
tinctly unfavorable  effect.  In  the  first  place,  she  found  it 
hard  to  breathe  freely  in  an  atmosphere  so  strongly  charged 
with  influences  in  which  her  intellect  could  take  but  little 
part;  and  then  she  found  in  it  a stimulus  to  emotions  which 
were,  by  nature,  only  too  easily  aroused.  With  her  acute 
intelligence  and  sympathy,  she  did  not  fail  to  become 
intensely  interested  in  the  Old  Testament  narratives,  and 
of  necessity  she  interpreted  them,  unconsciously,  in  her  own 
fashion.  God  became,  virtually,  the  equivalent  both  of 
her  adored  father,  and  also  of  her  critical,  over-watchful 
mother. (2)  Also,  the  instincts  which  she  learned  to  recognize 
later  as  typically  sexual  began  to  take  shape  and  to  become 
engrossing,  though,  for  the  time,  the  form  that  they  assumed 
was  thoroughly  mystical  and  spiritually  symbolic.  When 
only  four  years  old  she  conceived  of  God  as,  on  the  one  hand 
the  all-powerful  Creator,  even  of  new-born  children,  and 
at  the  same  time  as  a spirit,  or,  in  almost  the  literal  sense,  as 
wind  (see  the  “pursuit”  dream  No.  2 below).  Readers  of 
psychoanalytic  literature  will  remember  that  Freud,  in  the 
imagined  history  of  Leonardo,  refers  to  the  vultures  as  being, 
according  to  the  legend,  impregnated  by  the  wind,  as  if 
taking  the  place  of  a mysterious  and  powerful  deity.  This 
idea  was  my  patient’s  also,  and  she  proceeded  soon  to  apply 

2The  all-seeing  eye  of  God  (as  of  her  mother)  became  a source  of  terror,  em- 
phasized by  a Free-mason’s  diploma  which  her  father  had,  from  the  top  of  which  a 
glaring  eye  looked  out. 


James  J.  Putnam 


87 


it,  subconsciously,  with  reference  to  herself.  Two  of  her 
dreams  bear  on  this  point,  and  also  the  belief  which  she 
entertained  in  a thoroughly  simple  and  childlike  fashion, 
that  since  God  is  all  powerful  and  “a  spirit,”  and  as  children 
come  into  existence  through  his  fiat,  the  parent  might  be 
sexless  and  occupy  a wholly  passive  role.  The  wind  passes 
over  the  face  of  the  water  and  stirs  its  surface,,  thereby 
showing  its  presence  there,  as  the  angel  stirred  the  Pool  of 
Bethesda,  and  the  creation  of  new  life  follows  as  of  course. 
Through  this  idea  the  vital  significance  of  both  air  and 
water  took  on  for  her  a new  form  and  meaning  which  biology 
might  have  sanctioned. 

Moreover,  in  the  Old  Testament,  Jacob  and  others  had 
several  wives,  and  Jacob  worked  twice  seven  years  for 
Rachel.  Why,  then,  should  not  she,  as  well  as  her  mother, 
be  the  wife  of  her  adored  father?  And  was  not  this  the 
reason  why  she  should  yield  to  his  wishes  in  the  matter  of 
her  studies,  and  devote  seven  years  (as  actually  happened) 
in  working  for  him?  And  why,  then,  should  she  not  receive 
her  just  reward? 

It  is  significant,  as  illustrative  of  these  conflicts,  that 
my  patient  had  repeatedly,  between  the  ages  of  eight  and 
eleven  years,  a dream  which,  with  certain  modifications, 
recurred  in  later  life,  and  has  come  up  even  very  lately. 
I give  the  dream  in  her  own  words: 

“I  see  myself  wandering  through  an  empty  house. 
Suddenly  a dreadful  ogre  rushes  out  from  one  of  the 
rooms  and  pursues  me.  Without  wings  I seem  to  go 
up  stairs  and  yet  not  touch  them  with  my  feet.  I hide 
in  dark  closets  to  escape  the  ogre.  Then  I hear  him 
coming  and  I hurry  on  in  the  greatest  fear.  Now  I am 
far  in  advance,  now  he  almost  grasps  me.  Then  when 
I have  reached  the  last  gasp,  one  of  two  things  happens, 
—either  the  roof  opens  and  I float  out  heavenward  in 
relief  and  joy,  or  else  I fall  to  the  floor  in  a little  heap 
of  exhausted  despair.  At  that  instant  the  ogre  dis- 
appears. ” 

Every  student  of  dreams  knows  how  common  these 
“-pursuit”  dreams  are,  and  that  they  signify  at  once  a 


88  Sketch  for  a Study  of  New  England  Character 

longing  for  a pleasure  undefined  and  a shrinking  from  one’s 
own  unuttered  and  indeed  unutterable  emotions  as  being 
indefensible.  “Pursuit”  betokens  the  awakening  of  a 
desire  for  attention — natural  in  itself — which  startles  and 
terrifies  its  possessor  through  its  very  intensity,  its  myster- 
ious, vague  power,  its  warning  of  instinctive  cravings, 
strangely  familiar  yet  hitherto  unrecognized.  Its  signi- 
ficance in  this  case  is  emphasized  by  the  fact  that  when  she 
was  eight  years  old  (that  is,  when  these  dreams  began)  she 
had  an  experience  which  made  a profound  impression  and 
indeed  formed  the  beginning  of  a new  epoch.  As  she  was 
playing,  namely,  with  some  other  children  in  the  garret 
of  the  house  of  one  of  them,  some  boys,  a little  older  than 
they,  broke  in  on  them,  exposed  themselves  and  attempted 
to  throw  them  down;  tried,  in  short,  to  commit  an  assault 
on  them,  an  outcome  which  was  cut  short  by  a noise  which 
led  to  fear  of  interruption.  Not  only  this,  but  for  some 
time  afterwards  the  same  boys  continued  to  annoy  them  on 
the  street,  threatening  them  with  knives  drawn  with  dire 
vengeance  if  they  reported  them  at  home. 

Worst  of  all,  in  a psychological  sense,  was  the  fact  that 
the  fear  thus  excited,  great  as  it  was,  wras  accompanied  by 
an  amount  of  curiosity  and  desire  which  was  overwhelming 
and  disastrous,  especially  so  to  my  patient  on  account  of 
her  rigidly  religious  education,  for  this  had  led  her  to  regard 
her  only  real  and  admissible  self  to  be  a self  of  “spirit,”  free 
from  earthly  passions. (3) 

At  a much  later  date,  after  her  fancies  and  fantasies 
had  long  occupied  themselves  with  the  relation  between 
her  father  and  herself,  the  following  modification  of  her 
childhood  dream  occurred. 

“My  mother , my  sister , and  myself  are  living  in  a 
fine  old-fashioned  mansion.  It  is  light  and  airy,  having 
many  windows.  The  lovely  white-enamel  woodwork 
delights  me;  but  there  is  no  furniture  in  the  rooms. 

3 Some  fifteen  years  later  this  patient  had  an  analogous  experience  (psychologi- 
cally) which  revised  and  amplified  the  first.  She  was,  namely,  accosted  on  the 
village  street  by  an  adult  “exhibitionist”,  with  the  result  that  she  became  haunted 
by  terrifying  visions,  in  which  she  would  see  herself  lying  prostrate  at  his  feet,  as 
in  one  of  the  two  outcomes  of  her  “pursuit”  dreams  of  childhood. 


James  J.  Putnam 


89 


They  are  absolutely  bare.  The  house  stands  in  the 
midst  of  a beautiful  park  where  magnificent  oaks  are 
so  close  together  that  a bird’s-eye  view  of  their  tops 
would  show  a carpet  of  green.  I seem  to  see  myself 
high  in  the  air  enjoying  such  a view.  In  fact,  during 
the  first  few  moments  of  the  dream,  I am  outside  of 
the  house  looking  at  it  and  finding  pleasure  in  its 
beauties  and  the  charm  of  its  situation.  My  mother 
and  sister  are  in  an  inner  room  of  this  big,  square  man- 
sion. While  dreaming  I am  conscious  that  they  also 
represent  myself.  Then  I am  in  the  house  with  them. 
Without  warning  there  comes,  from  within  me,  a 
sensation  as  of  some  force  active  there.  In  an  instant 
it  is  outside  of  and  in  pursuit  of  me.  Beginning  like  a 
gentle  breeze,  it  increases  until  it  has  the  strength  of  a 
hurricane  which  nothing  can  withstand.  To  escape  its 
power  I run  into  a hall,  and  bolt  behind  me  three  doors 
there.  I have  shut  my  mother  and  sister  in  with  that 
‘dreadful  something!’  But  no;  it  cannot  be  confined. 

It  passes  through  the  bolted  doors  to  my  side  of  them. 
Then  the  ‘force’  is  no  longer  simply  a force,  but  it  be- 
comes a person  with  a purpose.  I rush  out  into  the  park. 
My  feet  leave  the  ground.  With  a superhuman  effort 
I make  my  way  in  the  air  to  the  tree-tops  where  I-walk 
along  on  the  huge  boughs  from  tree  to  tree,  trying  to 
conceal  myself  beneath,  or  behind,  the  foliage.  I look 
for  the  pursuer.  There  he  is  below  me — he  is  like- 
wise looking  for  me.  It  is  a man  on  horseback.  The 
horse  is  high-spirited,  is  turning  in  circles,  and  his  head 
is  held  erect  by  the  rider’s  firm  grasp  on  the  short  reins. 
The  horse  cannot  throw  that  man.  I watch  them  with 
interest.  Then  I find  myself  awake.  ” 

In  another  dream,  of  this  same  period,  she  saw  her 
father  and  herself  lying  side  by  side  and  realized  his  caresses 
with  gratification. 

I will  not  undertake  to  give  here  a full  analysis  of  this 
dream,  for  to  do  so  would  require  too  much  discussion. 
The  following  comments  are,  however,  of  especial  interest. 

I.  The  patient  has  no  “sister,”  though  as  a child  she 


90  Sketch  for  a Study  of  New  England  Character 

longed  for  one,  just  as  every  child  at  a certain  period  of  his 
infancy  longs  to  intensify  the  consciousness  of  himself  by 
discovering  or  assuming  some  duplicate  of  himself.  It  is 
well-known  to  students  of  dreams,  and  suggested  itself  at 
once  to  the  patient,  that  the  invention  on  her  part  of  the 
“mother  and  sister”  symbolized  a desire,  not  only  for  the 
duplication  of  herself  as  a complete  personality,  but  also 
the  intensification  in  thought  of  her  maternal  longing,  and 
her  womanly  longings  in  a general  and  specific  sense.  It 
will  be  noted  that  she  says  that  while  dreaming  she  was 
conscious  that  these  dream  personages  represented  herself; 
and  in  placing  them  in  the  “dark,  interior  room”  (as  she 
later  said)  of  the  mansion  which  she  makes  so  beautiful, 
she  symbolized  the  idea  of  their  central  position  in  relation 
to  her  interests  and  to  herself. 

2.  The  recognition  of  the  fact  that  the  “force”  which 
eventually  pursued  her  started  as  a stirring  within  herself , is 
of  distinct  interest,  because  it  indicates  an  accurate  repre- 
sentation of  the  truth.  It  is,  indeed,  our  own  feelings  that 
pursue  us. 

3.  Finally,  the  “force”  “becomes  a person  with  a 
purpose,”  and  from  the  secure  protection  of  the  tree-tops 
she  discovers  that  this  person  is  her  father,  whom  she  had 
so  strongly  wished  to  look  on  as  as  her  lover  and  whose 
power  and  manhood  she  delights  to  witness. 

The  dream  as  a whole  is,  in  short,  an  allegory  of  her 
life  of  imagination,  with  some  of  its  most  fundamental 
longings.  In  fact,  she  had  an  instinct  of  motherhood  which 
amounted  to  a strong  craving,  and  made  her  identify  herself 
with  her  own  mother  (as  an  obvious  exemplar  of  the 
maternal  instinct  and  in  spite  of  their  tacit  lack  of  sympathy) 
and  long  for  more  signs  of  affection  from  her  than  she 
actually  received.  At  one  period  she  tended  her  younger 
brother — then  an  infant — with  great  devotion  and  at  con- 
siderable sacrifice,  and  learned  to  think  of  him,  longingly, 
as  her  child.  In  her  fantasies  she  jumbled  together  her 
cravings  for  childhood  and  parenthood,  protection  and 
domination,  and  became  a person  perpetually  seeking  a 
fanciful  and  mystical  realization  of  gratifications  which  she 
could  not  practically  reach. 


James  J.  Putnam 


91 


It  may  be  of  interest  to  note  here,  as  throwing  a side 
light  on  some  of  the  tendencies  thus  far  referred  to,  that 
when  my  patient  was  between  two  and  three  years  old  a 
brother  was  born  who  was  a very  attractive  child,  and  she 
remembers  that  her  father  gave  him  some  attention; — 
“enough”  she  writes,  “to  arouse  in  me  a feeling  of  jealousy,” 
in  spite  of  the  fact  that  she  became  very  fond  of  the  child 
and  devoted  to  its  care.  A dream  which  she  had  when  still 
a little  girl,  in  which  she  represented  herself  as  terrified  by 
the  idea  that  her  brother  had  died,  may  be  taken,  if  the 
usual  interpretation  of  such  dreams  is  sound,  as  indicating 
the  activity  of  such  jealousy.  In  her  subconscious  thoughts 
she  wished  him  out  of  her  way  and  in  the  dream  she  saw  him 
very  vividly  as  dead. 

The  warmth  of  her  father’s  affection  for  my  patient  then 
came  in  to  accentuate  a tendency,  which  would  probably 
have  been  formed  even  without  that  cause  (if  only  as  a 
matter  of  compensation),  to  exalt  herself  in  her  own  eyes. 
She  felt  that  to  be  so  warmly  loved  was  proof  that  she  was 
worthy  of  being  loved.  Spurred  on  by  this  egoistic  ardor 
she  began  to  develop  a strong  ambition  both  to  excel  in 
school  and  to  conquer  in  such  simple  games  as  she  played. 
In  fact,  she  carried  so  far  the  passion  to  win  out  over  the 
rest,  that  it  interfered  curiously  with  their  comfort  and  her 
own. 

The  dream  about  her  baby  brother’s  death  was  followed, 
at  no  great  interval,  by  another  in  which  (presumably  in 
obedience  to  a suppressed  wish)  she  represented  her  mother 
as  having  died.  This  dream  also,  which,  with  some  reason, 
it  greatly  annoyed  her  mother  to  hear  told,  became  a source 
of  torture  to  her  conscience.  But  her  conscience  was  as 
complex  in  its  workings  as  were  her  other  tendencies,  and 
in  looking  back  at  the  incident  and  the  events  that  followed 
it,  she  writes: 

“Perhaps  as  an  atonement  for  the  sub-conscious 
crime  of  wishing  evil  I spurred  myself  on  to  renewed 
duty.  I was  as  cruel  to  myself  as  if  I had  been  striking 
my  body  with  a lash.  Also,  I tried  to  be  as  hard  with 
other  people  as  I was  on  myself,  which,  of  course,  caused 


92  Sketch  for  a Study  of  New  England  Character 

me  to  be  rather  disliked  by  my  schoolmates.  I did  not 
understand  why  they  felt  that  way,  for  I knew  I had 
only  kindly  feelings  toward  them.  I wanted  them  to 
do  right,  because  if  they  did  not  do  right  they  would 
suffer.” 

In  the  same  letter  she  writes,  further:  “Punish- 
ment was  always  connected  with  wrong-doing.  The 
reward  of  merit  system  was  in  full  force  in  those  days. 
The  good  child  was  rewarded  and  the  bad  child  pun- 
ished. The  good  child  always  obeyed  his  parents  and 
other  people  in  authority.  I tried  to  please  father  in 
order  to  deserve  his  affection.  I was  anxious  to  please 
mother  in  order  to  win  her  love.  Parents  decided  what 
was  good  for  their  children,  and  in  our  home  at  least 
there  could  be  no  appeal  from  that  decision.  It  was 
shown  to  be  our  duty  as  children  to  give  absolute 
obedience.  Independence  was  impossible,  and  the 
way  in  which  we  eased  our  spirits  from  the  undue 
pressure  was  to  imitate  our  parents  by  striving  to  have 
authority  over  our  school-mates,  through  endeavoring 
to  compel  them  to  do  the  things  which  we  called  right. 

. The  tendency  to  dominate  other  people, 
particularly  my  mates,  soon  caused  me  to  be  avoided. 
That,  and  the  fact  that  I was  kept  in  the  house  so  much, 
to  take  care  of  my  baby  brother,  made  me  a prey  to 
loneliness.  Then  I began  to  imagine  myself  different 
from  other  children.  A neighbor’s  child  exactly  my 
age,  was  doing  very  well  with  music.  My  progress  was 
compared  with  hers,  the  result  being  not  at  all  to  my 
credit.  The  lonelier  I grew,  and  the  more  unhappy 
I felt,  the  more  I clung  to  father.  His  love  for  me 
should  be  a comfort  for  all  my  disappointments. 

“This  tendency  to  lean  on  him  increased  year 
after  year,  so  that  when  I was  twelve  years  old  his 
approval  made  me  blissfully  happy  and  his  disapproval 
put  me  into  an  abyss  of  distress.  I never  seemed  to 
feel  real  happiness  apart  from  father.  That  was  a 
dangerous  state  of  affairs,  of  which  father  himself  had  no 
suspicion.  But  mother’s  eye  was  open  to  all  those 
things.  She  was  quite  certain  that  father  paid  me 


James  J.  Putnam 


93 


altogether  too  much  attention;  in  other  words,  she  was 
jealous.  No  doubt  I deserved  reproof,  but  I believe 
that  the  more  jealous  she  became  the  more  she  found 
fault  with  my  behavior.  However  that  may  have  been, 
it  is  unfortunate  for  any  child  to  be  tossed  about  be- 
tween the  conflicting  emotions  of  its  parents  ...  I 
came  by -my  own  intense  feelings  most  naturally,  as 
can  very  well  be  seen. 

“One  day  father  sent  me  a heart-shaped  valentine, 
made  of  white  gauze,  roses,  and  narrow  blue  ribbon. 

I thought  my  heart  would  burst  with  joy  when  I knew 
who  sent  this  love  token.” 

This  tension  was  somewhat  relieved,  at  one  point, 
through  another  influence,  equally  objectionable,  which 
she  describes  as  follows: 

“A  religious  revival  moved  the  city  to  its  depths. (4) 
For  two  or  three  months  during  one  winter  nearly  every 
one  attended  the  meetings.  They  were  well  calculated 
to  stir  up  almost  every  emotion  of  which  a human  being 
is  capable.  A great  number  of  Bible  subjects  were 
introduced  at  the  revival  meetings.  The  bliss  of 
Heaven  and  the  tortures  of  hell  were  both  pictured  to 
the  audience  in  vivid  colors.  It  is  not  to  be  wondered 
at  that  a sensitive  child,  like  myself,  should  suddenly 
begin  to  dream  of  the  Last  Judgment. 

“ (In  this  dream)  the  figure  of  Christ  was  floating 
high  above  me.  For  an  instant  I was  uncertain  whether 
I deserved  to  go  to  Him  or  not  (cf.  the  ogre  dream  of 
childhood,  above  described).  Would  he  receive  me? 
The  next  moment  a happy  little  soul  went  soaring 
heavenward.” 

There  are  many  other  features  in  the  case  to  which 
attention  might  properly  be  called,  but  I refer  only  to  one 
more  which  really  deserves,  in  large  measure,  to  be  men- 
tioned in  connection  with  her  father  worship,  and  also  as  a 

4This  lady’s  home  was  in  a city  in  another  part  of  the  country,  somewhat 
remote  from  Boston. 


94  Sketch  for  a Study  of  New  England  Character 

part  of  her  longing  for  domination.  This  is  a tendency 
almost  deserving  the  name  of  kleptomania,  which  showed 
itself  slightly  in  earlier  years,  and  again  at  a later  period, 
although  in  fact  the  actual  thefts,  such  as  they  were,  oc- 
curred but  a limited  number  of  times  in  all.  As  a little  girl 
she  stole  a pear  from  a fruit-dealer’s,  under  the  following 
conditions:  It  was  at  the  time  when  the  longing  for  dom- 

mination  was  very  strong  in  her,  and  to  have  the  upper  hand 
gave  a kind  of  exultation.  It  was  a form  of  excitement 
filled  with  fascination. 

“Not  far  from  my  father’s  office  there  was  a fruit 
store.  Sometimes  the  owner  stood  in  the  doorway; 
sometimes  he  was  half  concealed  in  the  darkness  of  the 
room.  But  wherever  he  might  be  he  kept  an  eye  on  the 
fruit-stand  in  front  of  the  store.  Just  because  he  was 
so  afraid  that  something  would  be  taken  from  him  I 
longed  to  snatch  a pear  or  an  apple  and  dash  out  of 
sight  before  he  could  seize  me.  I did  not  want  the 
fruit;  I wanted  to  ‘beat  him  at  his  own  game.’  He 
made  me  think  of  an  ugly  spider  ready  to  spring  on 
some  one.  I would  take  good  care  that  he  did  not 
catch  me.  The  right  moment  came.  In  a twinkling  I 
was  off  with  a pear;  in  another  twinkling  I had  thrown 
my  trophy  away.  At  first  I felt  quite  fine  over  my 
exploit.  But  then  the  New  England  conscience  came 
into  play  ...  I never  confessed  the  sin,  however. 
But  for  a long  time,  whenever  I passed  that  store, 
involuntarily  I quickened  my  steps  . . .” 

The  next  event  of  this  sort  was  when  she  and  her  brother 
exchanged  car  tickets,  that  they  had  given  them  to  go  to 
Sunday  School,  for  candy  from  a confectionery  store. 

Finally,  many  years  later, — in  fact,  within  a com- 
paratively recent  period, — some  much  more  important 
events  of  this  kind  occurred  which  should  justly  excite  the 
interest  of  the  student  and  which  may  justly  be  considered 
as  throwing  a new  light  on  the  otherwise  trifling  occurrences 
of  her  childhood.  On  three  occasions,  namely,  she  took 
a book  from  a second-hand  book-store,  and  on  several  other 


James  J.  Putnam 


95 


occasions  she  picked  up  from  a counter,  with  an  impulse 
to  carry  them  away  (which,  however,  she  did  not  allow  to 
completely  fulfil  itself)— at  one  time  a blue  leather  pocket- 
book,  at  another  a doll’s  pocket-book  of  the  size  of  a postage 
stamp,  at  another  a bit  of  narrow  baby  lace,  then  a scrap 
of  filet  curtain  lace,  again,  a white  belt  far  too  large  for  her, 
and  finally  some  small  pearl  buttons  similar  to  shoe  buttons 
and  also  pale  blue  in  color. 

What  was  the  cause  of  these  impulses  to  theft?  Cer- 
tainly not  any  desire  to  keep  or  own  the  articles  taken. 
For,  in  fact,  none  of  them  were  of  value  to  her,  and  all  were 
returned  except  two  of  the  three  books.  These  she  gave 
away  to  persons  whom,  for  the  gratification  of  her  own 
half  recognized  desires  she  wished  to  think  of  as  reading 
them  and  being  impressed  by  them.  Not  only  this,  but  she 
replaced  each  one  of  these  books  by  one  of  her  own  which 
she  considered  of  greater  value. 

It  is  worth  while  to  go  into  the  matter  a little  further, 
partly  for  its  intrinsic  interest  in  this  case,  partly  because 
thieving  of  this  general  character  represents  tendencies 
which  deserve  far  broader  study  than  they  commonly  receive. 

If  I have  succeeded  in  my  intention  I have  made  it 
clear  that  this  patient  was  a person  of  very  strong  emotions, 
which  did  not  lead  her  to  either  of  the  more  satisfactory 
outlets  of  marriage  and  the  establishment  of  a home,  or  to 
an  active  social  life  to  which  she  could  give  her  interests 
with  a whole  heart.  She  was  like  a stream  partially  dammed 
up  and  forced  to  find  its  exit  outside  its  normal  channel. 
As  a young  girl  she  had  greatly  wished,  as  I have  said,  to 
study  music,  and  if  this  could  have  been  made  possible  all 
might  have  been  well.  Another,  analogous  opportunity 
for  a satisfying  occupation  offered  itself  on  her  graduation 
from  college;  but  this  was  rejected  by  her  own  cross-purpose 
tendencies,  while  the  music  she  abandoned  in  obedience 
to  her  father’s  wish.  That,  to  her,  was  law,  and  without 
consciously  willing  it  her  father  strove  to  mould  her  life  in 
accordance  with  his  own  desires.  At  one  time  she  repelled 
a chance  to  marry,  still  under  the  control  of  the  wish  to  make 
her  father  all  in  all,  while  at  another  period,  when  something 
of  this  sort  might  well  have  come  to  pass,  she  drew  back  from 


96  Sketch  for  a Study  of  New  England  Character 

even  the  possibility,  in  consequence  of  a feeling  to  which  he 
had  given  expression,  that  she  ought  to  devote  that  period 
of  her  life  to  study. 

Being  the  sort  of  person  that  she  was,  there  was  nothing 
left  for  her  but  to  gain,  through  her  fancy  and  in  a symbolic 
way,  the  gratification  of  her  inhibited  wishes.® 

If  this  tendency  is  clearly  understood,  the  meaning  of 
the  thefts  will  readily  be  seen,  even  without  an  attempt  to 
interpret  them  at  length.  The  theft  of  the  pear  from  the 
fruit-stand  has  already  been  explained  in  the  patient’s  own 
words,  as  inspired  by  a desire  for  domination,  to  “get  the 
better  of  some  one,”  the  wish  to  outwit  somebody.  The 
thefts  of  the  books  will  be  better  understood  if  I say  that 
she  had  a dream  in  which  the  patient  represented  herself 
as  snatching  and  running  away  with  some  jewels  belonging 
to  her  sister-in-law,  and  hiding  them  in  a box  in  the  base- 
ment of  a house  half  demolished  as  if  through  a bomb.  The 
analysis  left  no  doubt  that  this  expressed  a desire  (really  felt 
but  not  consciously  accepted)  to  appropriate  her  brother’s 
children  as  born,  or  to  be  born,  of  herself.  This  sister-in- 
law  was  a person  of  dominating  character,  whom  she  felt 
to  have  stolen  her  brother  from  her,  yet  whom,  in  a sense, 
she  feared.  The  evidence,  which  I have  not  space  to  in- 
dicate, showed  that  my  patient  longed  to  regain  possession 
of  her  brother  for  herself  (or,  failing  that,  then  his  children), 
and  this  desire  showed  itself  in  indirect  form  just  after  the 
death  of  the  man  who,  but  for  her  father,  might  have  been 
her  lover. 

The  three  books  were  taken  after  she  had  broken  away 
from  another  male  friend  who  was,  in  a sense,  a lover  (though 
she  never  could  have  married  him)  and  who  stood,  in  a 
measure,  for  her  father — whom  books  always,  pre-eminently, 
symbolized  in  her  mind.  All  three  of  these  books  were — 
from  the  nature  of  their  contents — related  directly  or  in- 
directly to  her  repressed  wish  to  be  identified  with  her 
father.  The  leather  pocket-book  was  of  a color  of  which 
he  was  extremely  fond,  and  it  appeared  in  several  of  her 

5I  am  not  prepared  to  assert  that  my  patient’s  failures  were  due  quite  as  ex- 
clusively to  her  absorption  in  her  father  as  is  here  represented.  But  that  the  part 
played  by  this  influence  was  very  great  is  beyond  a doubt. 


James  J.  Putnam 


97 


dreams.  The  doll’s  pocket-book,  the  narrow  baby  lace,  and 
the  filet  curtain  lace  seem  to  have  been  taken  under  the 
impulse  of  longing  for  children  of  her  own;  and  in  fact,  one 
of  them  had  an  association  in  her  mind  with  a German 
story  she  had  recently  been  reading,  entitled  “Lace.” 
The  heroine  of  this  story  had  been  given  some  lace  by  her 
lover  as  an  engagement  present. 

Stated  in  this  off-hand  way,  the  explanations  here 
offered  may  carry  no  conviction;  but  those  who  are  familiar 
with  the  interpretation  of  dreams,  and  who  realize  that  the 
thoughts  expressed  in  dreams  differ  but  little  from  the 
instinctive  thoughts  of  daily  life,  will  be  more  inclined  to 
believe  that  they  are  true.  The  white  belt,  the  small  pearl 
buttons  of  pale  blue  color,  would  be  accepted  as  the  ex- 
pression of  other  wishes  in  the  same  class  if  there  were 
opportunity  to  present  the  evidence  at  length. 

To  summarize  the  teachings  of  this  case,  one  might  say 
that, — partly  in  consequence  of  ill  health  during  childhood 
and  adolescence,  partly  because  of  the  unwisely  stringent, 
emotionally’stimulating  training  to  which  she  was  subjected, 
partly  because  of  the  failure  on  the  part  of  her  devoted 
parents  to  recognize  her  best  needs, — this  patient  became 
like  a person  seeking  for  a hidden  treasure  that  she  had  never 
seen,  yet  which  she  felt  belonged  to  her,  picturing  it  with 
her  vivid  fancy  under  a thousand  forms  no  one  of  which 
corresponded  to  the  truth. 

The  tendencies  which  she  showed  as  regards  her  father 
and  her  mother  were  of  a kind  that  has  received  much 
attention  from  psychoanalysis,  and  might  be  considered  as 
constituting  a fairly  typical  illustration  of  the  psychological 
situation  to  which  the  name  of  “Oedipus  Complex”  has 
been  given. 

But  where  one  of  these  striking  tendencies  of  early 
childhood  (which  occur  even  with  normally  developing 
children,  though  in  a very  transient  and  evanescent  form) 
is  as  strongly  marked  as  in  this  instance,  it  rarely  if  ever 
forms  the  only  neurotic  feature  of  the  situation.  There  are 
four  or  five  phases  and  a larger  number  of  special  tendencies, 


98  Sketch  for  a Study  of  New  England  Character 

some  or  all  of  which  are  likely  to  stand  out  (in  the  course 
of  the  analysis)  in  greater  or  less  measure. 

I have  not  sought  to  bring  out  these  other  features  of 
the  case  (although  all  of  them  would  repay  study),  but  I will 
mention  the  two  principal  ones,  lest  it  should  seem  that  I 
had  overlooked  them. 

(1)  There  were  distinct  signs  of  an  accentuation  of  the 
so-called  “autoerotic”  period  of  earliest  childhood,  and  (2) 
equally  distinct  signs  of  the  tendency  to  emphasize  relation- 
ships with  persons  of  her  own  sex  familiar  to  every  one  under 
the  name  of  “crushes,”  or  as  intense  friendships.  The 
latter  tendency  was  especially  marked  in  one  rather  over- 
whelming friendship  that  lasted  nearly  fifteen  years,  and  the 
eventual  rupture  of  this  relationship,  through  a decided 
stand  taken  by  my  patient,  was  the  token  of  a growing  sense 
of  independence  and  insight  on  her  part. 

It  is  also  noteworthy  that  the  patient’s  compensatory 
wish-fulfilment  fantasies  took  on  many  curious  and  subtle 
forms.  One  of  these  consisted  in  the  very  frequent  employ- 
ment, in  her  dream  life,  of  the  number  “three,”  or,  rather, 
of  the  principle  of  triplification;  as  where  three  girls,  dressed 
just  alike  and  obviously  representing  a poly-plication,  and 
thus  an  intensification,  of  certain  wished-for  qualities  in 
herself,  presented  themselves  at  her  side  as  helpers  in  a time 
of  trouble. 

Every  one  is  aware  that  this  tendency  to  triplification, 
or — to  use  a more  convenient  though  inaccurate  terminology 
—the  use  of  “three”  and  its  multiples,  has  played  a larger 
part  in  the  history  of  mystic  thought  than  even  the  use  of 
five  or  seven.  Three  is  pre-eminently  a sacred  number,  and 
its  appearance  in  the  “trinity”  of  Christian  theology  is 
only  one  instance  out  of  a vast  number.  Usener’s  book, 
“Die  Dreiheit, ” gives  numerous  examples  of  the  tendency. 
In  seeking  for  an  explanation  of  this  widespread  Custom, 
that  careful  author  goes  no  further  than  the  idea  of  in- 
tensification through  an  extended  form  of  reduplication, 
the  number  three  being  considered  as  virtually  equivalent 
to  “indefinitely  large.”  I would  only  say,  in  supplementa- 
tion of  this  idea,  that  there  are  strong  and  instinctive  sex- 
connotations  to  the  number  three  and  that  these  came  into 


James  J.  Putnam 


99 


* 

play  in  the  case,  here  considered.  They  relate  partly  to  the 
family  idea — father,  mother,  child  (which  is,  of  course, 
contained,  amongst  others,  in  the  Trinity  conception) — 
and  also  to  other  matters. 

I have  said  that  the  effects  of  treatment,  in  this  case, 
were  eminently  satisfactory.  The  patient  feels  that  she 
has  had  a species  of  new  birth.  It  should  be  added,  how- 
ever, that  this  result,  while  it  would  have  been  impossible 
without  psychoanalytic  aid,  has  been  greatly  furthered  by 
congenial  work  and  an  increase  of  social  intercourse  of  a 
good  sort. 


PSYCHOPATHIC  APHONIA,  STAMMERING  AND 

CATALEPSY 


BY  BORIS  SIDIS,  M.  A.,  PH.  D.,  M.  D. 

Sidis  Institute , Portsmouth , New  Hampshire. 

SR.  Age  25.  Russian  Jewess.  Married;  has  four 
children.  Patient  was  brought  to  me  in  a state  of 
• helplessness.  She  could  not  walk,  and  was  unable 
to  utter  a word.  When  spoken  to  she  replied  in 
gestures.  When  challenged  to  walk,  she  made  unsuccessful 
attempts,  the  step  was  awkward,  the  gait  reeling,  the  body 
finally  collapsing  in  a heap  on  the  floor.  When  I shut  her 
eyelids,  the  eyeballs  began  to  roll  upwards,  the  lids  soon 
became  cataleptic,  and  the  patient  was  unable  to  open  them. 
When  I insisted  that  she  should  open  the  lids,  she  strained 
hard, — the  muscles  of  the  upper  part  of  the  body  became 
painfully  tense, — wrinkled  her  forehead,  and  contorted 
violently  her  face.  After  long  insistence  on  her  replying  to 
my  questions,  and  after  long  vain  efforts  to  comply  with  my 
request,  she  at  last  succeeded  to  reply  in  a barely  audible 
voice.  When  whispering  she  kept  on  making  inco-ordinate 
movements  with  jaws  and  lips,  began  to  shut  her  eyelids, 
rolled  up  the  eye-balls,  forced  the  tongue  against  the  teeth, 
stammered  badly  on  consonants,  uttering  them  with  great 
difficulty  after  long  hesitation,  the  sound  finally  coming  out 
with  explosive  force. 

I insisted  that  she  must  stand  up,  she  raised  herself 
slowly  and  with  long  effort,  made  a couple  of  steps,  and  sat 
down  at  once  on  the  chair.  During  the  period  of  effort  there 
was  marked  tremor  in  her  left  arm.  When  she  sat  down, 
she  threw  her  head  backward,  rolled  up  her  eyeballs,  and 
began  gradually  to  close  her  eyelids.  She  remained  in  this 
position  for  a couple  of  minutes,  and  then  began  spasmodically 
to  open  and  shut  the  eyelids.  When  taken  to  her  room, 
patient  walked  up,  though  with  some  difficulty,  three  flights 
of  stairs  without  the  nurse’s  support. 

Patient  was  greatly  emaciated,  she  lived  in  extreme  pov- 
erty. She  was  married  five  years,  and  had  given  birth  to 


100 


Boris  Sidis 


IOI 


four  children.  Patient  was  suffering  from  severe  headaches 
which  set  on  soon  after  the  birth  of  the  second  child.  At 
first  the  headaches  came  at  intervals  of  a few  weeks,  and 
lasted  about  a day,  then  with  the  birth  of  the  other  children 
the  headaches  grew  more  severe  and  more  frequent,  and 
finally  became  continuous.  From  time  to  time  the  attacks 
were  specially  exacerbated  in  violence,  she  then  complained 
of  terrible  pains  in  the  head,  excruciating  agony  toward  the 
vertex.  The  face  was  deadly  pale,  the  hands  and  feet  were 
ice-cold,  the  pulse  weak  and  sluggish.  During  the  attack 
the  head  had  to  be  raised,  since  in  any  other  position  the 
pain  was  unbearable.  The  pain  was  originally  unilateral, 
starting  on  the  left  side  of  the  head.  Of  late  the  pain  spread 
from  left  to  right.  The  whole  head  felt  sore,  like  a boil,  the 
scalp  was  highly  sensitive.  The  intense  attacks,  sweeping 
over  the  patient  unawares,  were  accompanied  by  twitchings 
of  the  eyelids,  rolling  of  the  eyeballs,  dizziness,  sparks  before 
the  eyes,  pains  in  the  left  side  of  the  chest,  and  by  numb- 
ness and  hypoaesthesia  of  the  face,  arms,  and  legs.  The 
patellar  reflex  was  markedly  exaggerated,  no  clonus  was 
present;  the  pupils  reacted  well  to  light  and  accommodation. 
The  field  of  vision,  however,  was  unsually  limited: 


Temporal  io 
Right  Field:  Nasal  5 

Upper  s 

Lower  8 


Temporal  15 
Left  Field:  Nasal  8 

Upper  12 

Lower  10 


The  patient  was  admitted  to  a local  hospital,  and  was 
allowed  to  nurse  her  one  year  old  baby.  Three  days  after 
admission,  while  nursing  her  baby,  she  was  suddenly  seized 
with  a violent  attack  of  headache  and  pain  in  the  left  side. 
The  arms  felt  numb  and  “gone.”  The  patient  was  seized 
with  a panic  that  the  child  might  fall;  hugging  the  baby  to 
her  left  breast  she  screamed  for  help  in  agony  and  terror. 
Immediately  following  this  seizure  the  patient  lost  her  voice, 
speech,  and  power  of  walking. 

After  staying  in  the  hospital  for  two  weeks  the  patient 
was  put  under  my  care. 

Patient  was  an  extremely  timid  creature.  She  lived  in 


102  Psychopathic  Aphonia , Stammering  and  Catalepsy 

Russia  in  a small  town  where  the  religious  persecutions  of  the 
neighbors  were  persistent  and  unremittent.  To  this  was 
joined  the  petty  annoyances  by  the  village  police  the  repre- 
sentatives of  which  acted  with  all  the  cruel  tyranny  charac- 
teristic of  the  old  Russian  regime.  The  patient’s  family  was 
in  constant  terror.  In  childhood  the  patient  has  undergone 
all  the  horrors  of  the  pogromi  with  all  the  terrors  of  inquisi- 
torial tortures.  Fear  was  the  very  essence  of  the  patient’s 
life.  She  was  afraid  of  everything,  of  her  very  shadow,  of 
anything  strange,  more  so  in  the  dark,  and  at  night.  With 
this  insistent  fear  which  was  the  basis  of  the  patient’s  mental 
life  there  were  also  associated  a great  number  of  superstitions 
to  which  her  mind  was  exposed  in  early  childhood,  and  in  her 
later  life.  The  patient  lived  at  home  in  the  fear  of  the  most 
savage  superstitions  and  prejudices  characteristic  of  the 
poor  ignorant  classes  of  Eastern  European  countries,  and 
outside  the  house  she  was  in  fear  of  her  life.  The  patient 
was  brought  up  on  fear  and  nourished  on  fear.  No  wonder 
when  she  was  run  down  and  met  with  a shock,  that  the  fear 
instinct  seized  on  her  and  gave  rise  to  the  symptoms  of 
physical  and  mental  paralysis. 

To  this  life  of  terror  we  may  add  the  extreme  poverty 
in  which  the  patient  lived  in  Russia  and  afterwards  in  this 
country.  The  hard  work  in  a sweat-shop  and  the  impaired 
or  ill  nutrition  ran  down  the  patient  and  further  predisposed 
her  to  disability  and  disease.  Patient  lived  in  constant 
dread  of  actual  starvation,  with  fear  of  having  no  shelter 
and  with  no  roof  over  her  head.  She  was  so  timid  that  she 
was  scared  by  any  sudden  movement,  or  by  a severe,  harsh, 
threatening  voice.  She  was  extremely  suggestible,  imitative, 
and  credulous.  She  was  like  a haunted  animal,  like  a scared 
bird  in  the  claws  of  a cat.  Fear  often  threw  her  into  a state 
of  rigidity. 

The  patient  suffered  from  a fear  of  fatigue,  from  fear 
of  exhaustion,  from  fear  of  disability,  from  fear  of  paralysis, 
pain,  sickness,  and  death.  The  fear  psychosis,  based  on 
an  abnormally  developed  fear  instinct  which  formed  the 
main  structure  of  her  symptom  complex,  had  a real  founda- 
tion in  the  psycho-physiological  condition  of  her  organism. 


Boris  Sidis 


103 


The  patient  actually  suffered  from  fatigue  due  to  exhaus- 
tion, underfeeding,  and  overworking. 

Married  at  the  age  of  twenty,  she  bore  four  children  in 
succession.  This  was  a drain  on  the  poor  woman,  and  further 
weakened  her  feeble  constitution.  Her  husband  was  a poor 
tailor  working  in  a sweat-shop,  making  but  a few  dollars  a 
week.  The  family  was  practically  kept  in  a state  of  chronic 
starvation.  The  wolf  was  hardly  kept  away  from  the  door. 
The  family  was  in  constant  dread  of  “slack  time”  with  its 
loss  of  employment  and  consequent  privations  and  suffering. 

The  husband  was  a hard  worker,  did  not  drink,  but  the 
long  hours  of  work,  the  low  wages,  the  poor  nutrition,  the 
vicious  air,  and  the  no  less  vicious  environment,  cheerless, 
and  monotonous,  sometimes  gave  rise  to  moods,  discontent, 
anger,  and  quarrels  of  which  the  patient  with  her  timidity 
stood  in  utter  terror. 

The  patient’s  dream  life  was  strongly  colored  by  a 
general  underlying  mood  of  apprehension.  The  fear  instinct 
formed  the  soil  of  the  whole  emotional  tone  of  the  psychosis, 
waking,  subwaking,  dreaming,  conscious,  and  subconscious. 
Again  and  again  did  the  nurses  and  attendants  report  to  me 
that,  although  the  patient  was  aphonic  and  it  was  hard  to 
elicit  from  her  a sound,  in  her  sleep  she  quite  often  cried  out, 
sometimes  using  phrases  and  words  which  were  hard  to 
comprehend,  because  they  were  indistinct,  and  because  they 
were  sometimes  in  her  native  language.  When  awakened 
immediately,  it  was  sometimes  possible  to  elicit  from  her 
shreds  of  dreams  in  regard  to  scares  and  frights  about  herself, 
about  her  children,  about  her  husband,  relatives,  and  friends. 
When  she  came  under  my  care  the  patient  often  used  to 
wake  up  in  the  morning  in  a state  of  depression  due  to  some 
horrible  hallucinatory  dreams  in  which  she  lived  over  again 
in  a distorted  form,  due  to  inco-ordination  of  content  and  to 
lack  of  active,  guiding  attention,  dreams  in  which  the  dreadful 
experience  of  her  miserable  life  kept  on  recurring  under 
various  forms  of  fragmentary  association  and  vague  syn- 
thesis, brought  about  by  accidental,  external  and  internal 
stimulations. 

The  patient  was  taken  to  her  room  in  the  evening,  and 
put  to  bed.  During  the  night  she  was  somewhat  restless, 


104  Psychopathic  Aphonia  Stammering  and.  Catalepsy 

kept  on  waking  up,  but  on  the  whole,  according  to  the 
nurse’s  account,  she  slept  quite  well.  In  the  morning  the 
patient  had  a hearty  breakfast,  and  felt  better  than  the  day 
before  when  she  was  brought  to  me.  The  voice  improved 
somewhat  in  strength  and  volume.  During  the  day  she 
rested,  felt  well,  and  enjoyed  her  meals.  Speech  was  still 
in  a whisper  barely  audible,  but  there  was  no  stammering, 
no  muscular  inco-ordination,  no  twitchings  of  the  face. 
About  four  in  the  afternoon  patient  sat  up  in  bed,  her  voice 
became  somewhat  stronger,  though  speech  was  still  in  a 
whisper.  This  improvement  lasted  but  a few  minutes. 
When  her  arms  were  raised,  the  left  hand  manifested  con- 
siderable tremor  and  weakness  as  compared  with  the  right 
arm.  (See  Tracing  I.)  After  having  made  a few  remarks 
which  apparently  cost  her  considerable  effort,  she  had  a 
relapse,  she  again  lost  her  voice,  and  was  unable  to  whisper. 
I insisted  that  she  should  reply  to  my  questions;  she  had  to 
make  a great  effort,  straining  her  muscles  and  bringing  them 
into  a state  of  convulsive  inco-ordination  before  she  could 
bring  out  a few  sounds  in  reply.  A little  later,  about  ten  or 
fifteen  minutes  after  I left  the  room,  the  nurse  came  in  and 
quietly  asked  her  a question,  the  patient  answered  in  a 
whisper,  with  little  strain  and  difficulty.  In  an  hour  later 
the  patient  regained  her  speech  for  a short  period  of  a few 
minutes.  These  changes  went  on  during  the  patient’s 
waking  period.  Once  towards  evening  the  patient  regained 
her  voice  and  speech  to  such  an  extent  that  she  could  talk 
with  no  difficulty  and  little  impediment;  the  voice  was  so 
resonant  and  strong  that  it  could  be  heard  in  the  hall  ad- 
joining the  room.  This  however  lasted  but  a few  moments. 

After  having  had  a good  night’s  sleep  patient  woke  up 
in  good  condition;  appetite  was  good.  Voice  was  clear, 
though  low.  She  was  in  a state  of  lassitude  and  relaxation. 
I attempted  to  examine  her  and  kept  testing  her  condition, 
physical  and  mental.  I was  anxious  to  make  a psychognosis 
of  the  patient’s  case.  The  tests  and  the  questions  strained 
her  nervous  system  by  requiring  to  hold  her  attention,  and 
by  keeping  her  in  a state  of  nervous  and  mental  agitation. 
She  looked  scared,  anxious, — the  scared,  haunted  look  in  her 
face  reappeared.  The  patient  was  no  more  than  about 


Boris  Sidis 


105 

twenty  to  twenty-five  minutes  under  experimentation  when 
a severe  headache  of  the  vertex  and  of  the  left  side  of  the  head 
set  on.  The  eyeballs  began  to  roll  up,  eyelids  were  half 
closed;  lids  and  eyeballs  were  quivering  and  twitching. 
The  hands  were  relaxed  and  looked  like  paralyzed.  When 
raised  they  fell  down  by  her  side  in  an  almost  lifeless  condi- 
tion. There  was  marked  hypoaesthesia  to  pain  and  heat 
sensations.  The  anaesthesia  was  more  marked  on  the  left 
than  on  the  right  side.  The  left  arm  when  raised  and  kept 
for  a few  seconds  showed  marked  tremor  as  compared  with 
the  right  arm.  This  is  to  be  explained  by  the  fact  that  the 
exacerbations  of  the  headache,  of  pain,  and  the  general  cata- 
leptic seizures  set  in  usually  during  or  after  the  nursing 
periods.  The  infant  while  nursing  was  kept  by  the  mother 
on  the  left  arm,  the  left,  side  thus  bearing  the  pressure,  weight, 
and  strain, — it  was  with  the  left  side  that  fear  became  mainly 
associated.  (See  Sidis,  The  Causation,  Ch.  Psychopathic 
Reflexes.) 

During  the  height  of  the  attack  the  patient  was  quiet- 
ened, her  fears  allayed,  and  a five-grain  tablet  of  phenacetine 
was  given  her  with  the  authoritative  remark  that  the  drug 
was  sure  to  help  her.  As  soon  as  she  swallowed  the  tablet 
the  patient  opened  her  eyes,  and  said  she  felt  better.  About 
an  hour  later,  when  another  attempt  at  an  examination  was 
made,  patient  had  an  attack  of  headache,  cried,  said  she  was 
afraid,  but  she  answered  in  a whisper  when  spoken  to.  She 
talked  slowly,  in  a sort  of  staccato  way.  I insisted  that  she 
should  talk  a little  faster  and  enounce  the  words  distinctly. 
She  made  violent  attempts  to  carry  out  my  command,  but 
got  scared,  began  to  hesitate,  and  stammer,  her  voice  and 
speech  rapidly  deteriorating  with  her  efforts,  ending  in 
complete  mutism. 

During  the  day  I tried  from  time  to  time  to  keep  up 
the  experiment  of  insisting  that  the  patient  should  speak, 
and  every  time  with  the  same  result  of  bringing  about  an 
attack.  Patient  began  to  stammer  and  stutter,  becoming 
more  and  more  frightened  the  more  the  nurse  and  myself 
insisted  that  she  should  make  an  effort  and  reply  to  our 
questions.  Still  when  the  patient’s  attention  became  dis- 
tracted, when  she  was  handled  gently,  when  her  fears  were 


106  Paychopathic  Aphonia,  Stammering  and  Catalepsy 

allayed,  the  speech  and  sound  improved  in  quality  and  in 
loudness,  and  at  times  her  sentences  were  quite  fluent,  her 
enunciation  quite  distinct. 

This  state  of  instability  lasted  for  several  days  until  the 
patient  became  somewhat  familiar  with  the  surroundings. 
In  one  of  her  better  moments  the  patient  told  me  that  she 
thought  her  stammering  began  with  a definite  event.  One 
evening  when  she  was  fatigued  with  the  labors  of  the  day 
for  her  family,  a stammerer  came  in  to  see  her.  The  stam- 
mering made  a strong  impression  on  her.  She  felt  the  strain 
of  the  stammerer  in  his  efforts;  she  could  not  control  the 
sympathy  and  the  strain,  and  involuntarily  began  to  imitate 
his  speech.  She  began  to  fear  that  she  might  continue  to 
stammer  and  be  unable  to  enunciate  sounds  and  words.  The 
more  she  feared  the  harder  it  was  for  her  to  speak  or  even 
to  use  her  voice. 

In  regard  to  the  limitation  of  the  field  of  vision,  it  may  be 
interesting  to  note  the  fact,  that  although  the  field  was 
narrowed  down  to  5 and  10,  subconsciously  it  showed  to  be 
normal  in  range.  Patient  could  guess  objects  lying  outside 
the  conscious  field  of  vision,  narrowed  down  by  her  malady. 
The  outlying  visual'  field  may  be  termed  the  subconscious 
field.  Now  when  tested  the  subconscious  field  was  co-extensive 
with  the  normal  field.  At  times  the  subconscious  extended 
beyond  the  normal.  Patient  could  guess,  although  she  could 
not  see  when  directly  questioned,  all  kinds  of  objects,  such 
as  keys,  knives,  pencils  inserted  into  the  subconscious  field. 
Objects  inserted  on  the  periphery  of  the  normal  field  could  be 
guessed  by  her  more  often  than  by  a person  with  a normal 
field  of  vision.  In  fixating  the  eye  I watched  her  pupil  close- 
ly, it  was  found  to  be  steady  and  immobile.  Thus  a white 
strip  of  paper  which  the  patient  could  not  see  unless  it  was 
brought  within  the  range  of  10  or  5 degrees  could  be  guessed 
by  her  even  when  held  on  the  periphery  of  85. 

A few  days  later  the  patient  began  to  improve,  she 
began  to  adapt  herself  to  her  surroundings,  and  did  not  get 
so  easily  scared.  Along  with  it  the  field  of  vision  began  to 
improve.  Concentration  of  attention  could  be  prolonged 
without  getting  fatigued  with  consequent  headaches  and 
their  concomitant  manifestations  of  paralysis,  tremor, 


Boris  Sidis 


107 


aphonia,  and  muscular  and  more  specially  of  oculo-motor 
inco-ordinations.  When  patient  was  approached  quietly 
and  slowly  without  arousing  any  suspicion  of  danger,  thus 
avoiding  the  arousal  of  the  fear  instinct,  the  field  of  vision 
manifested  considerable  expansion: 


Temporal 

42 

Temporal 

3° 

Right  Field:  Nasal 

25 

Left  Field:  Nasal 

40 

Upper 

25 

Tipper 

25 

Lower 

25 

Lower 

30 

About  eight  days  after  first  examination  patient  woke 
up  one  morning  in  a state  of  depression;  she  cried  a good  deal. 
She  did  not  sleep  well  the  night  before,  dreamt  and  worried 
on  account  of  her  children.  She  was  afraid  that  something 
might  have  happened  to  them  in  her  absence,  perhaps  they 
were  sick,  perhaps  the  husband  could  not  take  good  care  of 
them.  She  talked  in  a whisper,  her  eyes  were  shut.  When 
I insisted  on  opening  the  eyelids,  she  opened  them,  but  did 
it  with  difficulty.  I put  her  into  a hypnotic  state.  In 
about  a minute  her  eyes  rolled  up,  and  lids  shut  spasmodical- 
ly. There  was  present  a slight  degree  of  catalepsy.  Mu- 
tism was  strongly  marked.  Upon  sudden  and  unexpected 
application  of  an  electric  current,  the  patient  opened  her 
eyes,  cried  out,  but  soon  relapsed  into  a state  of  lethargy. 
Gradually  patient  was  brought  out  of  the  lethargic  state. 

A couple  of  hours  later,  after  she  had  had  a good  rest 
a few  more  experiments  as  to  her  sensori-motor  life  were 
attempted.  I asked  her  to  raise  objects,  tested  her  sensi- 
tivity to'  various  stimulations,  her  concentration  of  atten- 
tion, asked  her  questions  about  her  life,  about  her  family, 
took  again  her  field  of  vision.  All  that  was  a great  effort  to 
her.  While  I was  taking  her  field  of  vision  the  patient’s 
eyes  began  to  close,  and  it  took  about  twenty  seconds  before 
she  could  open  them.  She  opened  them  with  effort,  but  shut 
them  again.  This  time  it  took  her  about  45  seconds  before 
she  could  open  the  lids.  Fatigue  set  on  sooner  with  each 
repetition  of  experiment  and  test,  and  lasted  a longer  time. 

For  several  days  patient  kept  on  improving  slowly. 
She  then  had  another  relapse.  She  slept  well  the  night 


108  Psychopathic  Aphonia,  Stammering  and  Catalepsy 

before,  but  woke  up  early  about  six  in  the  morning,  she 
began  to  worry  about  her  family,  and  complained  of  head- 
ache. About  half  past  eight  the  headache  became  severe, 
there  was  again  pain  in  the  left  side,  the  left  hand  began  to 
tremble,  and  felt  anaesthetic,  the  eyelids  closed,  and  could 
not  open,  aphonia  returned,  in  fact  she  fell  into  a state  of 
mutism.  About  ten  o’clock  patient  opened  her  eyes,  but 
she  was  unable  to  talk.  After  long  insisting  on  her  reply  to 
my  question  as  to  how  she  was,  she  finally  replied  in  a whis- 
per: “Well,”  then  added  “I  have  a bad  headache.”  She 
had  great  difficulty  in  replying  to  my  questions,  moved  her 
jaws  impotently  before  she  was  able  to  emit  a sound,  her 
muscles  were  strained,  the  face  was  set,  tense,  and  drawn, 
the  brow  was  corrugated,  the  eyeballs  rolled  up,  and  the 
eyelids  shut  tightly.  Patient  was  unable  to  raise  her  hands, 
they  lay  powerless  at  her  side.  When  raised  the  arms  were 
found  to  be  lethargic,  fell  to  her  side,  only  the  left  hand 
manifested  light,  fibrillary  twitchings  and  a gross  tremor. 
When  insisted  upon  that  she  must  raise  her  arms,  she  be- 
came agitated,  scared,  began  to  moan  and  cry.  Claimed 
severe  pain  in  head,  in  chest,  in  heart.  “Pain  in  heart,  in 
head,  I am  afraid,”  she  moaned  in  a whisper.  There  was 
loss  of  kinaesthetic  sensibility,  patient  complained  that  she 
did  not  feel  her  arms,  “ they  are  not  mine.  ” She  had  to  look 
at  the  arm  in  order  to  find  it.  There  was  also  present  an- 
aesthesia to  other  sensations  such  as  pain,  touch,  heat,  and 
cold.  After  a couple  of  hours’  rest  the  sensibility  returned. 
The  sensibility  was  affected  more  on  the  left  side  than  on  the 
right,  and  also  returned  earlier  on  the  right  side. 

When  the  fatigue  and  the  scare  subsided  the  patient  was 
tested  again.  This  time  the  reactions  to  sensory  stimula- 
tions were  normal.  Patient  was  touched,  pinched,  and 
pricked,  she  reacted  to  each  stimulus  separately,  and  was 
able  to  synthesise  them  and  give  a full  account  of  their 
number.  Kinaesthetic  sensibility  was  good, — she  was  fully 
able  to  appreciate  the  various  movements  and  positions  in 
which  her  limbs  and  fingers  were  put. 

Patient  was  left  to  rest,  quietened,  treated  carefully, 
avoiding  sudden  stimulations,  allaying  her  fears  and  sus- 
piciousness of  danger,  lurking  in  the  background  of  her 


Boris  Sid  is 


109 

mind.  After  a few  hours  she  sat  up,  made  an  attempt  to 
raise  herself  from  bed,  got  up  with  some  effort,  and  sat  down 
in  an  easy  rocking  chair  next  to  her.  Her  eyes  were  wide 
open.  Asked  how  she  was,  she  replied  in  a whisper  that 
she  felt  quite  well.  The  effort  however  fatigued  her,  her 
head  began  to  drop,  eyelids  began  to  close,  and  the  eyeballs 
began  to  roll  up.  Twitchings  were  observed  in  the  eyelids, 
and  tremor  in  the  left  arm.  She  was  again  put  to  bed  and 
given  a rest  of  a few  hours.  She  opened  her  eyes,  and  told 
me  that  she  was  weak.  This  statement  she  herself  volun- 
teered. I found  that  she  could  move  her  hands  easily,  and 
that  the  numbness  was  completely  gone. 

For  a whole  week  the  patient  kept  on  growing  in  health 
and  in  strength,  her  sensori-motor  reactions  improved,  she 
walked  round  the  room  for  a few  minutes,  talked  in  a low 
voice  for  a quarter  of  an  hour  at  a time  without  manifesting 
her  symptoms  of  fatigue;  her  appetite  and  sleep  improved 
accordingly.  At  the  end  of  the  week  there  was  again  a 
relapse, — she  did  not  sleep  well  the  night  before,  dreamt  of 
being  hunted  and  tortured,  woke  up  depressed,  had  no 
appetite  for  breakfast,  complained  of  headache,  pains, 
worries,  and  fears.  The  headaches  have  abated  in  their 
virulence  during  last  week,  but  now  they  seemed  to  have 
reappeared  in  their  former  vigor.  When  I began  to  examine 
her  she  looked  frightened,  her  eyeballs  rolled  up,  her  eyelids 
closed.  The  aphonia  was  severe,  patient  lost  speech  and 
voice.  When  spoken  to  she  could  not  answer.  Asked  if 
she  heard  me,  she  shook  her  head  affirmatively.  There  were 
slight  twitchings  of  her  left  hand  and  also  of  the  muscles  of 
her  face.  When  attention  was  attracted  to  the  arm  the 
twitchings  increased  in  violence  and  rapidity.  \\  ith  the 
distraction  of  the  attention  the  twitchings  disappeared. 
When  the  left  hand  was  put  in  the  patient’s  field  of  vision, 
thus  making  her  attention  concentrate  on  that  limb,  the 
tremors  increased  again,  becoming  finally  convulsive  in 
character. 

I insisted  she  should  try  to  open  her  mouth,  and  say 
something, — she  made  fruitless  efforts,  moving  inco-ordinate- 
ly  the  muscles  of  the  face  and  of  the  forehead,  but  she  could 
not  utter  a sound.  She  could  not  move  her  arms  on  com- 


no  Psychopathic  Aphonia,  Stammering  and  Catapelsy 

« 

mand.  could  hardly  wriggle  the  fingers  of  her  hand.  She 
appeared  like  a little  bird  paralyzed  by  fear.  When  the 
arm  was  raised  passively  it  fell  down  slowly  being  in  a cata- 
leptic state. 

I allayed  the  patient’s  fear.  I strongly  impressed  her 
with  the  groundlessness  of  her  fears,  and  also  with  the  fact 
that  everything  was  well  with  the  children,  and  that  her 
husband  will  be  good  and  gentle  with  her.  The  patient  was 
permitted  to  see  her  family.  The  husband  was  made  to 
realize  that  he  must  treat  her  with  more  consideration.  He 
came  often  to  visit  her,  and  learned  to  treat  her  well.  He 
soon  found  a better  position,  was  advised  to  remove  to  a 
healthy  locality  and  to  more  cheerful  surroundings.  The 
children  were  well  cared  for.  The  patient  found  deep  satis- 
faction in  the  midst  of  this  family  happiness.  The  fear  state 
abated, — the  patient  became  more  confidential,  more  hopeful 
for  the  future,  and  began  to  improve.  The  infant  was 
weaned  so  that  the  strain  of  nursing  was  removed.  The 
patient’s  appetite  began  to  increase;  she  gained  several 
pounds  in  a few  days.  Long  periods  of  examination  and 
investigation  of  her  nervous  and  mental  state  no  longer 
exhausted  or  terrified  her.  Her  concentration  of  attention 
could  be  kept  up  from  a quarter  to  half  an  hour  at  a stretch 
without  giving  rise  to  fatigue,  headache,  or  to  a seizure  with 
its  consequent  psychomotor  effects.  The  haunted  look  of 
fear  disappeared,  and  along  with  it  were  also  gone  the  fatigue 
and  dread  of  physical  and  mental  exercise  or  work.  She 
could  work  and  walk  with  ease  the  whole  length  of  the  room 
and  of  the  hall.  She  began  to  take  more  and  more  interest 
in  her  appearance  and  in  dress.  For  many  minutes  at  a 
time  she  looked  out  on  the  street  taking  an  interest  in  all 
that  was  done  and  what  was  going  on.  The  field  of  vision 
taken  at  this  stage  of  the  patient’s  condition  was  markedly 
increased,  almost  approaching  the  normal: 

Right  Temporal  50-80  Left  Temporal  60-88 

Field:  Nasal  45-60  Field;  Nasal  55-62 

LTpper  35-40  Upper  38-45 

Lower  40-62  Lower  54-60 

(See  Chart  II.) 


Boris  Sid  is 


in 


In  a couple  of  weeks  the  patient  no  longer  complained 
of  headaches  and  pains;  she  felt  strong  and  well;  her  voice, 
speech,  movements,  reactions  became  normal.  Sudden 
stimulations  no  longer  scared  her,  nor  did  they  bring  about 
any  attacks  of  tremors,  trembling,  anaesthesia,  aphonia, 
mutism,  and  catalepsy.  (See  Tracings  I,  II.)  The  patient 
was  sent  home,  and  stayed  well. 


Charts  and  Tracings 


Chart  I gives  field  of  vision  taken  the  first  few  days  of 
treatment.  The  chart  shows  gradual  enlargement  of  field. 


o.  G. 


o.  D. 


CHART  il. 


1 12  Psychopathic  Aphonia , Stammering  and  Catalepsy 

Chart  II  gives  field  of  vision  taken  the  last  few  days 
before  the  patient  went  home.  The  chart  shows  an  almost 
normal  field.  The  field  of  vision  became  enlarged  under 
the  influence  of  stimulations  which  the  patient  regarded  as 
beneficial  to  her  health. 


Tracing  I shows  the  tremor  of  her  right  and  left  arm 
respectively.  The  upper  vibrations  are  of  the  right  arm,  the 
lower  vibrations  are  of  the  left  arm.  The  tracing  above  the 
lower  vibrations  is  the  time  line. 


Tracing  II  gives  the  tremors  of  right  and  left  arms. 
The  tracing  was  taken  the  day  before  the  patient  left.  Both 
arms  give  the  same  reactions  and  show  no  difference  in  their 
vibrations  and  tremors.  The  upper  tracing  is  the  time  line. 


Boris  Sidis 


ii  3 

The  case  is  essentially  one  of  functional  psychosis  of 
the  Psychosomatic  variety  (See  Sidis,  Symptomatology). 
Like  all  such  cases  the  symptoms  manifested  are  due  to 
Associated  Psychopathic  Reflexes  and  instinctive  Fear 
reactions  (See  Sidis,  Causation ). 

I am  glad  to  find  that  psychologists,  such  as  J.  B.  Wat- 
son, as  well  as  medical  men  are  coming  round  to  my  teach- 
ings of  Functional  Psychosis  as  constituting  at  bottom  psycho- 
biological , psychopathic  Associated  Reflexes  and  Fear  Reac- 
tions of  early  life  experience.  I devoted  to  this  work  years 
of  psychopathological  research  and  clinical  labor.  It  is  but 
just  to  ask  that  the  results  of  my  long  scientific  activity 
and  arduous  labors  in  the  domain  of  Psychopathology 
should  not  be  piled  on  that  heap  of  Austro-Germanic  Pseudo- 
analysis which  is  akin  to  Astrology,  Alchemy,  Cheiromancy, 
Oneiromancy,  and  generally  to  Mediaeval  symbolism, 
occult  exegesis,  Oriental  mystical  interpretation,  scholastic 
allegorical  subtleties,  and  generally  to  the  pseudo-philo- 
sophical, pseudo-scientific  savage  and  barbaric  speculations 
and  practices  of  Sympathetic  and  Imitative  Magic.  It 
is  but  right  to  ask  of  the  psychologist  and  psychopath- 
ologist as  well  as  of  all  fair  minded  medical  men  that  my 
scientific  results  in  the  domain  of  Psychopathology,  such 
as  the  Associated  Psychopathic  Reflexes  and  FearReactions 
of  Functional  Psychosis  should  be  referred  to  my  work  to 
which  I had  devoted  a life  time  of  unremitting  research 
and  arduous  labor. 


SUGGESTIONS  FOR  A SCHEME  OF  GRAPHIC 
REPRESENTATION  OF  PERSONALITY 
AND  PSYCHOSIS 

BY  H.  DOUGLAS  SINGER,  M.  D.,  M.  R.  C.  P. 

Director , Illinois  State  Psychopathic  Institute , 
Kankakee , III. 

THE  more  one  studies  the  various  disorders  of  con- 
duct included  under  the  heading  of  insanity,  the 
more  one  is  compelled  to  regard  the  make-up  or 
personality  of  the  patient  as  of  paramount  impor- 
tance in  determining  the  picture  presented.  One  and  the 
same  disease-process  may  be  associated  with  the  most  widely 
divergent  types  of  clinical  “insanity.”  Not  only  so,  but 
one  symptom-picture  may  follow  any  one  of  a number  of 
different  precipitating  factors,  including  such  dissimilar  con- 
ditions as  somatic  disease  and  purely  psychic  difficulties. 

It  is  quite  true  that  irritation  and  destruction  (be  it 
temporary  or  permanent)  of  nerve  tissue,  due  to  disease,  give 
rise  to  direct  manifestations  of  such  interference  with  func- 
tion in  the  form  of  excitement,  convulsion,  sense-falsification, 
clouding  of  consciousness,  amentia,  dementia,  etc.,  which 
are  as  a rule  readily  recognizable  as  such.  The  particular 
grouping  of  these  features  depends  upon  the  kind  of  func- 
tional disturbance  (t.  e.  wdiether  irritative  or  destructive) 
and  upon  the  localization  of  the  damage.  But  the  reactions 
of  the  patient  under  these  new  conditions,  brought  about  by 
the  disease  process,  depend  in  the  first  place  upon  his  per- 
sonality or  habitual  modes  of  adjustment.  Such  disease 
conditions  may  thus  be  looked  upon  as  nature’s  experiments 
whereby  the  individual’s  characteristic  modes  of  reaction, 
whether  inherited  or  acquired,  are  brought  into  prominence. 

On  the  other  hand  those  disorders  of  conduct  which 
become  obvious  as  the  result  of  psychic  difficulty,  be  this 
because  of  inherent  difficulty  in  the  situation  to  be  faced  or 
because  of  poor  equipment  with  which  to  meet  conditions  of 
moderate  complexity  or  even  of  every-day  nature,  may  be 
regarded  as  uncomplicated  examples  of  personal  modes  of 

114 


H.  Douglas  Singer 


115 

reaction.  This  group,  probably  much  the  larger  of  the  two, 
includes  those  disorders  known  as  functional  neuroses  and 
psychoses  and  offers  for  study  the  more  severe  types  of 
faulty  adjustment. 

Until  quite  recent  times  the  psychiatrist  has  regarded 
his  patients  as  necessarily  subjects  of  some  disease  process, 
more  or  less  mysterious  in  nature.  It  is  interesting  also  to 
notice  that  in  some  instances  where  definite  disease-process 
is  actually  present,  as  in  the  deliria  of  specific  fevers,  there 
has  been  a tendency  to  consider  these  cases  as  more  or  less 
distinct  from  insanity.  Yet,  in  spite  of  this  consistent 
attitude  and  improved  methods  of  study  and  care,  it  must 
be  admitted  that  the  recovery  rate  among  the  insane  has 
changed  but  little  in  many  years.  Gradually  the  conclusion 
is  being  accepted  that  the  hope  for  the  insane  lies  in  preven- 
tion  rather  than  in  cure.  All  recent  work  in  psycho-analysis 
and  allied  fields  emphasizes  the  importance  of,  and  the 
dangers  which  belong  with,  failure  to  satisfactorily  meet  the 
demands  of  libido  under  the  conditions  of  social  life  and 
demonstrate  that  this  can  be  remedied  only  by  education 
with  the  object  of  establishing  some  mode  acceptable  to 
society  and  satisfying  to  the  individual.  To  accomplish  this 
it  is  obviously  essential  to  be  able  to  recognize  faulty  habits 
of  adjustment  at  a stage  sufficiently  early  to  permit  of  some 
hopes  of  their  modification. 

While  something  has  been  accomplished  towards  this 
end  but  little  use  has  yet  been  made  of  the  results  of  nature’s 
experiments  available  for  study  in  the  hospitals  for  the  in- 
sane. One  of  the  reasons  for  this  would  appear  to  be  the 
great  difficulty  of  standardizing  the  analyses  of  these  con- 
ditions and  putting  them  into  a form  sufficiently  concise  to 
be  grasped  as  a whole  and  thus  affording  the  means  for  mak- 
ing generalizations.  In  offering  the  present  suggestions  for 
a scheme  having  this  as  an  objective  I wish  it  to  be  clearly 
understood  that  it  is  not  presented  as  a finished  product 
but  as  a working  basis  from  which  to  start.  I fully  realize 
that  it  is  open  to  many  objections  not  the  least  of  which  is 
the  danger  of  becoming  routine  and  diagrammatic.  This, 
however,  is  not  inherent  in  the  scheme  and  would  constitute 
a distinct  abuse. 


1 1 6 Graphic  Representation  of  Personality  and  Psychosis 

In  selecting  a skeleton  outline  for  an  analytical  scheme 
it  is  necessary  to  subdivide  by  natural  lines  of  cleavage  which 
shall  be  as  free  as  possible  from  purely  conventional  and 
abstract  concepts  and  shall  yet  be  susceptible  of  use  under 
the  many  apparently  divergent  views  of  biologic  psychology. 
It  must  be  concise  and  yet  capable  of  detailed  extension  in 
any  desired  direction.  The  terms  used  must  be  carefully 
defined  and  will  probably  have  to  be  the  subject  of  conven- 
tion before  final  adoption.  The  headings  here  employed 
have  been  used  as  far  as  possiblein  a literal  sense  but  will 
be  explained  in  so  far  as  seems  necessary. 

The  analysis  is  not  intended  to  replace  a detailed  descrip- 
tion which,  indeed,  is  necessary  for  its  making.  Not  the 
least  advantage  which  is  to  be  found  from  its  use  is  the  check 
which  it  places  upon  the  description  of  facts  which  are  so 
often  found  to  be  deficient  in  some  particulars  when  one 
comes  to  study  them.  Let  me  also  insist  that  the  detailed 
record  must  contain  facts  and  not  merely  the  opinions  of  the 
informants.  This  is  not  always  an  easy  task  and  is  one 
that  needs  continual  emphasis.  The  charts  represent  the 
opinion  of  the  investigator,  not  of  the  source  of  information, 
but  it  should  be  always  open  to  re-statement  from  the  record 
of  fact. 

Besides  the  record  of  personality  as  evidenced  by  re- 
actions prior  to  “insanity”  an  effort  is  also  made  to  analyze 
the  results  of  examination  and  observation  in  the  hospital. 
This  can  of  course  be  made  for  any  particular  period  and  as 
frequently  as  seems  advisable.  It,  therefore,  justly  deserves 
the  description  of  “psychosis.”  With  a sufficient  number 
of  such  records  of  personality  and  psychosis  it  should  be 
possible  to  determine  correlations  between  traits  of  personal- 
ity and  features  more  or  less  ominous  and  characteristic  of 
various  insanities  and  also  to  point  out  the  need  for,  and 
the  direction  of,  more  detailed  analyses  along  certain  lines. 
The  general  scheme  is  outlined  below  in  Chart  I which  also 
represents  the  form  on  which  we  have  been  recording  them. 

It  will  be  noted  that  for  graphic  representation  there 
are  shown  against  each  feature  under  consideration  a set  of 
six  small  squares  for  personality  and  a similar  set  for  the  psy- 
chosis. The  presence  of  any  particular  quality  is  indicated 


H.  Douglas  Singer 


II 7 

by  blacking  in  the  corresponding  squares.  Since  some  of 
these  qualities  must  be  present  to  some  degree  in  all  persons 
it  becomes  necessary  to  use  some  method  for  designating 
quantity.  Wherever  this  has  appeared  necessary  the  con- 
vention has  been  adopted  of  indicating  an  average  intensity 
by  blacking  in  4 squares,  a less  than  average  by  2 and  an 
excess  by  6.  Wherever  the  numerical  designation  has  not 
seemed  necessary,  that  is  to  say  where  the  particular  trait 
represents  a non-essential  element,  its  absence  is  indicated 
by  leaving  the  squares  blank  and  its  presence  by  blacking  in 
4 squares,  thus  corresponding  with  the  width  used  as  indica- 
tive of  the  average  in  those  designated  quantitatively.  It 
may  be  that  it  would  be  better  to  employ  indications  of 
degree  throughout  but  at  present  this  has  not  seemed  neces- 
sary. 

The  headings  to  the  left  of  the  chart  represent  traits  of 
personality  and  are  applicable  in  the  figures  both  for  person- 
ality and  psychosis.  Those  on  the  right  are  more  definitely 
technical  terms  derived  from  the  usual  descriptions  of  fea- 
tures met  with  in  neuroses  and  psychoses.  The  separation 
of  these  two  groups  in  this  way  may  possibly  place  undue 
emphasis  upon  the  conventional  distinction  between  features 
which  may  be  regarded  as  within  the  limits  of  the  normal 
and  those  which  are  definitely  pathological,  the  so-called 
“symptoms”  of  insanity.  Features  listed  in  the  picture  of 
the  psychosis  under  the  heading  of  endowment  may  well  be 
the  direct  result  of  disease  and  thus  strictly  pathological 
but  those  under  the  title  of  adjustments  are  in  all  probability 
merely  the  outcome  of  the  evolution  of  traits  of  personality 
and  are  thus  pathological  only  in  degree.  Indeed,  one  of  the 
chief  objects  of  this  work  is  to  determine  what  particular 
modes  of  adjustment  need  special  care  and  training  because 
they  lead  by  natural  evolution  to  such  conduct  as  to  render 
the  person  adopting  them  incapable  of  life  in  society. 

The  general  plan  of  analysis  adopted  aims  first  at  a 
distinction  between  the  endowment  of  the  individual  on  the 
one  hand  and  his  mode  of  using  this  endowment  in  the 
struggle  for  self-  and  race-preservation  on  the  other.  The 
former  represents  the  tools  with  which  the  individual  must 


1 1 8 Graphic  Representation  of  Personality  and  Psychosis 


ENDOWMENT  personality  psychosis 
VIGOR  or  EXPRESSION 
ENEQfiV  DOMINANCE 

initiative 

BODILY  RESISTANCE 


MOOD 


HAPPY 
SAD 
COLORLESS 
OSCILLATING 

NATIVE  INTELLIGENCE  " T~- 


ADJUSTMENT 
PRIMITIVE  SENSUAL 

|TTj-1 

DOMESTIC 

HELPFUL 

ARTISTIC 

HARMLESS  HOBBIES 
IRRITABLE 

. OVERSCRUPULOUS 

EXPLOSIVE  AFFECTS 

HYPOCHONDRIA 
DRUG  ADDICTION  P"  ’ 1 ' 


CLOUDING 

i ' *"V'~ 

SENSE-  FALSIFICATIONS 

LOSS  OF  MEMORY' 



CONFABULATION 

. ' 

i 

PERSEVERATION 

MONOTONY 

. >' 

SUSPICIOUS 


HARMFUL 


BASHFUL 
SUPERSTITIOUS 
DAY-DREAMING  ~ | j '?  \ ; 


MANNERISMS 


3T1MULAB&JTY 

FLIGHT 

DIFFICULTY 


EERPLEXED 

APPREHENSIVE 

ANXIOUS 

OBSESSIONS 

HYSTERICAL  FEATURES 


IDEAS  OF  REFERENCE 
HALLUCINATIONS 
PARANOIC  TRENDS 
HEBEPHRENIC  FEATURES 
FEELING  OF  INFLUENCE 
AUTOCHTHONOUS  IDEAS 
SCATTERING 
NEOLOGISMS 
PHANTASIES 
ECSTASY 

WITHDRAWAL  OF  INTEREST 
PSEUDOSPONTANEQUS  MOVEMENT 
STEREOTYPIES 
KATATONIC  FEATURES 


CHART  I. 

Form  at  present  in  use  for  graphic  records  of  personality 
and  psychosis. 

work,  the  latter  the  manner  of  using  them  which  he  adopts. 
Endowment  must  necessarily  be  indicated  quantitatively. 

Every  individual  is  endowed  with  certain  fundamental 
desires  and  appetites.  It  is  unfortunate  that  these  words 
lay  stress  upon  the  consciousness  of  these  cravings  for  they 
are  primarily  and  essentially  inherent  in  living  cells.  They 
represent  the  effort  of  life  to  perpetuate  itself.  Indeed  the 
evolution  of  consciousness  is  the  result  and  not  the  source  of 
these  desires  and  merely  affords  better  means  for  accom. 


H.  Douglas  Singer 


119 

plishing  the  preservation  of  self  and  race.  This  primitive 
libido  or  energy  then  must  be  present  in  all  persons,  but 
while  it  cannot  differ  in  kind  it  yet  may  in  degree.  Our 
estimate  of  this  degree  must  be  made  by  a study  of  the 
vigor  of  the  reactions  which  the  individual  shows  and  the 
titles  selected  seem  to  be  sufficiently  explicit  to  indicate  the 
features  which  are  weighed  in  reaching  a conclusion.  It  is 
probably  well  to  insist,  however,  that  in  so  doing  attention 
is  paid,  not  to  the  quality  of  the  effects  accomplished  but, 
to  the  energy  with  which  they  are  carried  out.  Under  the 
head  of  “bodily  resistance”  the  points  considered  are  re- 
sistance to  fatigue,  recuperation  with  rest,  tolerance  for 
alcohol  or  other  toxins  (e.  g.  the  specific  fevers),  bodily  re- 
action under  strains  of  various  kinds,  etc. 

The  second  subhead,  mood,  is  to  be  understood  only  as 
covering  the  general  trend  and  is  to  be  distinguished  from 
affect  or  emotion  which  are  reactions  or  adjustments.  By 
the  term  mood  I understand  that  conscious  background 
which  seems  to  depend  upon  the  degree  of  functional  activity 
and  the  relative  harmony  or  disharmony  of  action  between 
the  various  functions  of  the  body.  No  effort  has  been  made 
to  express  degree  under  this  heading  for  the  reason  that  it  is 
difficult  to  estimate  the  relation  of  happiness  to  sadness  as 
thus  understood  and  the  energy  involved  has  already  been 
considered.  Instead,  the  four  different  headings  have  been 
used  to  cover  the  various  possibilities  which  may  present 
themselves. 

The  third  subhead  is  one  which,  although  extremely 
important,  I have  not  yet  succeeded  in  satisfactorily  estimat- 
ing by  historical  review  of  a patient’s  life.  It  is  a matter  of 
the  greatest  difficulty  to  differentiate  in  analysis  between  real 
intellectual  endowment  and  the  consequences  of  variation 
in  energy  and  modes  of  adjustment  in  determining  the  ac- 
quisitions and  accomplishments  of  the  patient.  All  charts 
thus  far  constructed  have  therefore  this  space  left  blank 
and  the  heading  is  added  only  for  the  sake  of  completeness. 

The  additional  features  under  endowment  in  the  column 
for  the  psychosis  need  no  explanation  and  there  will,  I think, 
be  no  objection  to  the  place  assigned  to  them.  The  sub- 
division of  intellectual  dementia  here  made  is  perhaps  un- 


120  Graphic  Representation  of  Personality  and  Psychosis 

necessarily  detailed  but  is  the  outcome  of  a system  of  symp- 
tom-analysis by  card-index  which  we  maintained  for  some 
time  before  this  present  system  of  charts  was  initiated. 

The  portion  of  the  analysis  dealing  with  modes  of  ad- 
justment is  more  liable  to  critical  objection  and  revision  for 
the  reason  that  it  deals  with  much  that  is  but  little  under- 
stood and  trenches  more  closely  upon  personal  views  of 
behavioristic  psychology.  As  will  readily  be  seen  the  group- 
ing starts  with  the  natural  (or  extra-social)  reactions  and 
then  passes  to  the  socially  required  substitutions.  In  ar- 
ranging these  some  effort  has  been  made  to  place  them  in  a 
more  or  less  logical  sequence  beginning  with  those  more 
successful  and  proceeding  with  a progressively  increasing 
scale  of  unsatisfactoriness.  The  earlier  examples  thus  will 
represent  true  sublimations,  the  later  more  definite  failures. 
This  may  be  regarded  as  an  a priori  judgment  of  the  problem 
under  consideration  but  the  grouping  is  of  course  subject  to 
alteration  as  the  facts  become  definitely  established.  Some 
orderly  arrangement  was  necessary  and  the  one  adopted 
seemed  justified  by  general  experience. 

Certainly  the  primitive,  frank,  sensual  modes  of  reaction 
and  to  a considerable  extent  the  helpful  substitutions  are 
used  more  or  less  by  all  persons.  Hence  it  has  seemed  neces- 
sary to  estimate  these  features  in  a quantitative  manner  and 
the  same  convention  has  been  adopted  as  in  connection  with 
endowment.  All  others  are  indicated  merely  as  forming  a 
definite  part  of  the  individual’s  habits  of  adjustment  or  as 
being  absent. 

Under  the  heading  of  sensual  are  to  be  included  the 
entirely  frank,  natural  gratifications  of  libido  so  characteristic 
of  healthy  childhood  which  are  more  or  less  banned  by 
society  and  hence  must  be  sublimated.  The  questions  con- 
sidered under  this  heading  seem  sufficiently  obvious  to 
require  no  special  discussion  here.  The  very  essence  of 
them  is  frankness.  Under  psychosis  in  connection  with 
sensuality  have  been  added  distractibility,  flightiness  and 
so-called  retardation  or  difficulty  of  reaction  which  seem  to 
me  to  represent  exaggerations  in  this  sphere. 

The  sublimations  or  balancing  factors  are  grouped 
under  the  title  of  helpful  substitutions.  They  represent 


H.  Douglas  Singer 


121 


direction  of  energy  into  various  channels  here  designated  as 
domestic,  social,  practical  and  artistic.  These  interests  are 
described  as  helpful,  and  this  result  of  analysis  should  only 
be  reached  where  the  following  holds  true,  for  the  reason 
that  they  represent  modes  of  adjustment  which  serve  the 
purpose  of  satisfying  desire  and  at  the  same  time  promote 
the  welfare  of  society.  In  weighing  the  value  of  such  efforts 
at  adjustment  consideration  must  be  given  to  the  frankness 
with  which  they  are  made.  Especially  with  the  group 
designated  “artistic”  is  this  true.  It  is  quite  possible  to 
simulate  an  interest  in  such  matters  as  a cloak  for  a failure 
to  make  any  real  adjustment  at  all.  The  test  in  every  case 
must  be  real  accomplishment  or  activity  in  the  field  selected, 
mere  dreaming  along  such  lines  cannot  satisfy  the  craving 
for  action  which  is  the  prime  meaning  of  desire.  Errors  will 
probably  be  made  with  considerable  frequency  in  using  this 
column  but  necessarily  such  pseudo-interest  and  failure  of 
adjustment  will  be  further  evidenced  by  the  presence  of 
activities  which  will  fall  into  the  category  of  harmful  sub- 
stitutions. 

The  next  subhead  is  that  of  harmless  substitutions  by 
which  are  meant  those  activities  which  are  capable,  when 
frankly  adopted,  of  affording  some  degree  of  compensation 
or  outlet  for  the  energy  which  is  socially  prohibited  in  its 
natural  form  but  which  represent  no  real  gain  to  society 
although  they  bring  no  reason  for  conflict  with  social  law. 
They  will  thus  include  interests  which  are  often  called  hobbies 
such  as  collecting,  the  adoption  of  animals,  etc. 

The  last  group  of  harmful  substitutions  is  by  far  the 
most  important  from  the  standpoint  of  the  sociologist  and 
psychiatrist.  They  are  called  harmful  for  the  reason  that 
they  do  not  accomplish  the  sublimation  desired  and  serve  to 
bring  the  individual  more  or  less  into  conflict  with  his  environ- 
ment. 

The  first  of  these,  “irritable,”  seems  fairly  free  from 
possible  misunderstanding  and  represents  the  substitution 
of  aimless  activity  for  a frank  and  purposeful  method  of 
dealing  with  a given  situation  of  more  or  less  emotional 
coloring.  Irritability^  in  the  place  of  frank  emotion  accom- 
plishes nothing  except  to  provide  an  outlet  for  energy  and 


122  Graphic  Representation  of  Personality  and  Psychosis 

illustrates  in  an  extremely  simple  manner  what  is  meant  by 
substitutive  types  of  reaction.  Persons  who  adopt  such 
modes  are,  for  some  reason,  unable  to  meet  difficulties 
squarely  and  as  some  reaction  is  imperative  they  merely 
move  instead  of  acting.  Obviously  such  inadequate  re- 
sponses are  very  frequent  and,  in  deciding  that  these  traits 
are  a characteristic  of  any  given  person’s  habitual  way  of 
dealing  with  situations  of  more  or  less  difficulty,  care  must 
be  exercised  in  studying  the  facts. 

Next  to  this  has  been  placed  “over-scrupulous.”  By 
this  wre  mean  to  include  those  tendencies  to  hesitate  over  a 
decisive  action,  to  worry  over  the  facts  and  to  question  the 
adequacy  of  any  response  which  may  have  been  made.  The 
chief  characteristic  is  thus  an  indecision,  always  accompanied 
by  more  or  less  futile  worrying  and  a tendency  to  great 
exactitude  in  detail  whereby  the  situations  to  be  faced  are 
kept  as  constant  as  possible. 

Under  the  heading  “explosive  affects”  are  included 
severe  emotional  reactions  upon  slight  occasion,  tantrums, 
more  or  less  transient  enthusiasms  such  as  religious  fervor, 
etc.  Everyone  is  more  or  less  liable  to  outbursts  of  intense 
emotion  on  occasion  and  the  recognition  of  such  features  as 
a factor  in  the  personality  must  depend  upon  a study  of  the 
relation  of  the  reaction  to  the  situation  calling  it  forth  and 
the  frequency  or  habitualness  of  such  exhibitions. 

“Hypochondria”  is  understood  as  a failure  to  face  actual 
conditions  with  the  substitution  of  an  explanation  in  the 
form  of  bodily  incapacity  which  avoids  the  necessity  for 
direct  reaction  and  at  the  same  time  gives  a reason  for  the 
failure  to  obtain  true  satisfaction  and  the  consequent  emo- 
tional distress. 

“Drug  addiction”  has  been  given  a special  place  but  is 
to  be  designated  only  where  there  is  evidence  in  the  mode  of 
its  use  that  it  has  been  adopted  as  a substitute  for  adequate 
adjustment. 

The  term  “suspicious”  covers  the  tendency  to  translate 
failures  in  accomplishing  results  into  interference  on  the 
part  of  others  and  to  see  a meaning  in  happenings  which  so 
alters  the  facts  of  the  situation  as  to  render  frank  adjust- 
ment to  the  real  facts  more  or  less  impossible.  With  this 


H.  Douglas  Singer 


123 


type  of  adjustment  there  is  perhaps  less  appearance  of 
indecision  and  ineffectiveness  than  in  some  others  for  the 
reason  that  the  reactions  made  are  appropriate  to  the  situa- 
tion as  it  appears  to  the  actor  and  thus  more  or  less  orderly 
and  purposeful.  The  substitution  seems,  as  it  were,  to  take 
place  in  the  grasp  of  the  problem  instead  of  in  the  mode  of 
adjustment. 

By  “bashful”  is  understood  the  awkwardness  and  gauch- 
erie  when  face  to  face  with  reality  which  are  so  often  seen 
as  a temporary  adaptation  in  the  adolescent  period  of  life. 
It  needs  no  further  description  but  should  be  used  only 
where  this  seems  to  be  an  habitual  reaction.  It  would  un- 
questionably be  a relatively  constant  feature  in  charts  made 
during  adolescence.  It  is  quite  possible  that  this  is  given  a 
place  too  low  in  the  scale. 

“Superstitious”  is  applied  to  a tendency  to  ascribe  personal 
failures  to  unknown  influences  which  thus  lessen  responsi- 
bility and  avoid  the  need  for  self-reliance  and  definite  deci- 
sion. Under  this  heading  will  come  some  forms  of  so-called 
religious  observance  in  which  the  beliefs  play  the  part  of  sub- 
terfuge excuse  instead  of  frank  and  helpful  activities  which 
we  would  class  with  artistic  or  perhaps  social  interests. 
This  illustrates  well  the  need  for  a close  analysis  of  the  facts 
stated  by  informants  before  deciding  the  value  to  be  ascribed 
to  any  particular  descriptive  adjective. 

“Day-dreaming”  and  “mannerisms”  are  perhaps  the 
most  difficult  of  all  to  clearly  define.  The  former  quite  ob- 
viously applies  to  the  tendency  to  seek  the  gratification  of 
desires  by  imagining  the  end  as  accomplished.  But  the  chief 
result  upon  the  individual’s  conduct  and  appearance  as 
viewed  by  the  onlooker  is  simply  one  oi  retirement  from 
contact  with  definite  activities  and  thus  there  is  given  a 
decidedly  negative  tone  to  the  character.  It  will  be  neces- 
sary to  deduce  the  fact  of  dreaming  by  weighing  all  facts 
available,  including  the  apparent  mood  and  the  actual  ac- 
complishments which  result  from  the  abstraction.  By 
mannerisms  are  to  be  understood  the  various  odd  and  per- 
haps, on  the  surface,  inexplicable  habits  of  speech  and  con- 
duct which  seem  peculiar  to  this  particular  individual.  As 
with  all  other  features,  it  is  important  to  study  the  meaning 


124  Graphic  Representation  of  Personality  and  Psychosis 

of  such  habits  in  relation  to  the  situations  which  call  them 
forth  and  not  merely  to  accept  blindly  an  opinion  by  the 
informant  as  to  the  presence  or  absence  of  such  traits. 

The  technical  terms  used  in  the  right  hand  column  are 
fairly  generally  understood  and  do  not  require  special  defini- 
tion in  this  paper.  It  is  true  that  some  are  very  broad  such 
as  “hysterical  features”  by  which  one  would  understand  the 
presence  of  convulsions,  anaesthesia,  spasm,  paralysis,  etc., 
of  hysterical  type,  while  others  are  more  detailed.  The 
reason  for  this  dissimilarity  lies  mainly  in  personal  interests 
on  the  part  of  the  writer.  It  may  be  well  to  explain,  how- 
ever, that  the  term  hallucination  is  here  used  in  a sense  some- 
what more  restricted  than  is  usually  given  to  it.  The  writer 
has  been  in  the  habit  of  including  under  this  name  only  those 
forms  which  do  not  depend  upon  falsification  of  sense  per- 
ception, experienced  characteristically  in  connection  with 
clouding  of  consciousness  and  intoxication.  Hallucinations, 
in  contradistinction  to  sense-falsifications,  of  this  type  have 
been  included  with  autochthonous  ideas,  ideas  of  reference 
and  pseudo-spontaneous  movements  as  intrapsychic  falsi- 
fications and  it  is  in  that  sense  that  the  term  is  applied  in 
this  outline. 

In  order  to  illustrate  the  use  of  the  system  a few  speci- 
mens are  here  appended.  Chart  II  represents  the  analysis 
of  a clear-cut  example  of  a manic-depressive  exaltation. 
The  predominance  of  frank  features  is  striking,  especially 
when  contrasted  with  Chart  III  which  represents  a case  of 
hebephrenic  dementia  praecox.  The  lack  of  energy  in  the 
latter  and  the  predominance  of  efforts  at  sublimation  along 
artistic  lines  is  clearly  shown.  The  failure  is  also  indicated 
by  the  adoption  of  harmful  substitutions. 

In  Chart  IV  is  depicted  an  example  of  a paranoid  reac- 
tion in  which  some  of  the  same  elements  noted  in  Chart  III 
are  also  seen  but  in  which  there  is  a striking  difference  in 
regard  to  energy  endowment  which  seems  to  be  an  important 
factor  in  determining  the  character  of  the  picture. 

Chart  V represents  the  analysis  of  a case  of  very  com- 
plex type  in  which  the  clinical  classification  has  been  made 
of  a mixed  form  of  a manic-depressive  reaction  although 
some  have  regarded  it  as  a dementia  praecox  reaction.  The 


H.  Douglas  Singer 


125 


analysis  here  made  seems  to  show  features  belonging  to 
both  frank  and  shut-in  types  of  personality  with  again  an 
excess  of  energy. 


ENDOWMENT 

VIGOR  OP  EXPRESSION 

rurnrv  dominance' 

ENERGY  initiative 

BODILY  RESISTANCE 


MOOD 


HAPPY 
SAD 
COLORLESS 
OSCILLATING 
.NATIVE  INTELLIGENCE 


ADJUSTMENT 
PRIMITIVE  sensual 


helpful 


HARMLESS 


DOMESTIC 

SOCIAL 

PRACTICAL 

ARTISTIC 

HOBBIES 

IRRITABLE 


OVERSCRUPULOUS 

EXPLOSIVE  AFFECTS 

HYPOCHONDRIA 
DRUG  ADDICTION 
SUSPICIOUS 


HARMFUL 


BASHFUL 

SUPERSTITIOUS 

DAY-DREAMING 


MANNERISMS 


CLOUDING 

SENSE- FALSIFICATIONS 


LOSS  OF  MEMORY 

CONFABULATION 

CIRCUMSTANTIALITY 

PERSEVERATION 

MONOTONY 


STIMULABILITY 

FLIGHT 

DIFFICULTY 


PERPLEXED 
• APPREHENSIVE 
ANXIOUS 
OBSESSIONS 

HYSTERICAL  FEATURES 


IDEAS  OF  REFERENCE 
HALLUCINATIONS 
PARANOIC  TRENDS 
HEBEPHRENIC  FEATURES 
FEELING  OF  INFLUENCE 
AUTOCHTHONOUS  IDEAS 
SCATTERING. 

NEOLOGISMS 
PHANTASIES 
ECSTASY 

WITH  ORA  WAL  OF  INTEREST 
PSEUDOSPONTANEDUS  MOVEMENT 
STEREOTYPIES 
KATATONIC  FEATURES 


CHART  II — Analysis  of  a case  of  manic  excitement. 


Finally  in  Chart  VI  is  shown  a composite  picture  made 
up  from  the  analysis  of  25  unselected  cases  of  dementia 
paralytica.  The  size  of  the  shaded  areas  represents  the 
average  of  all  cases  and  one  can  readily  see  how  such  pictures 
can  be  used  for  sorting  out  the  essential  from  the  accidental 


126  Graphic  Representation  of  Personality  and  Psychosis 

manifestations  of  the  disease.  The  loss  of  endowment  and 
interest  is  obvious  and  there  are  certain  added  features  be- 
longing to  the  manifestations  of  intoxication.  The  cases 


ENDOWMENT 

VIGOR  OF  EXPRESSION 

rurorv  dominance 

ENERGY  INITIATIVE 

BODILY  RESISTANCE 


MOOD 


HELPFUL 


DOMESTIC 

SOCIAL 

PRACTICAL 

ARTISTIC 


HARMFUL 


1 1 


HAPPY 
SAD 
COLORLESS 
OSCILLATING 
NATIVE  INTELLIGENCE 


ADJUSTMENT 
PRIMITIVE  SENSUAL 


X I 


HARMLESS  hobbies 

IRRITABLE 

OVERSCRUPULOUS 

EXPLOSIVE  AFFECTS 

HYPOCHONDRIA 
DRUG  ADDICTION 
SUSPICIOUS 


BASHFUL 
SUPERSTITIOUS 
. DAY-DREAMING 


MANNERISMS 


CLOUDING 

SENSE-  FALSIFICATIONS 


LOSS  OF  MEMORY 

CONFABULATION 

CIRCUMSTANTIALITY 

PERSEVERATION 

MONOTONY 


STIMULABIUTY 

FLIGHT 

DIFFICULTY 


PERPLEXED 

APPREHENSIVE 

ANXIOUS 

OBSESSIONS 

HYSTERICAL  FEATURES 


IDEAS  OF  REFERENCE 
HALLUCINATIONS 
PARANOIC  TRENDS 
HEBEPHRENIC  FEATURES 
FEELING  OF  INFLUENCE 
AUTOCHTHONOUS  IDEAS 
SCATTERING 
NEOLOGISMS 
PHANTASIES 
ECSTASY 

WITHDRAWAL  OF  INTEREST 
PSEUOCSPONTANEOUS  MOVEMENT 
STEREOTYPIES 
KATATONIC  FEATURES 


CHART  III — Analysis  of  a case  showing  a hebephrenic  type 
of  dementia  praecox  reaction. 


from  which  this  chart  was  made  were  unselected  but  it  is 
obvious  that  correlations  can  well  be  illustrated  by  selecting 
some  certain  features  and  combining  all  cases  showing  this 


H.  Douglas  Singer 


127 


feature  and  comparing  with  one  from  those  in  which  it  was 
absent. 

The  object  of  this  paper,  however,  is  not  the  demonstra- 
tion of  special  traits  for  which  much  more  time  and  work  are 


ENDOWMENT 

VIGOR  or  EXPRESSION 

rurorv  dominance 

itNERST  INITIATIVE 

BODILY  RESISTANCE 


MOOD 


COLORLESS 
OSCILLATING 
NATIVE  INTELLIGENCE 


ADJUSTMENT 
PRIMITIVE  sensual' 


HELPFUL 


HARMLESS 


. DOMESTIC 
SOCIAL 
PRACTICAL 
ARTISTIC 

HOBBIES 

IRRITABLE 


OVER  SC  RU  P UL  H US 

EXPLOSIVE  AFFECTS* 

HYPOCHONDRIA 
DRUG  ADDICTION 
SUSPICIOUS 


HARMFUL 


BASHFUL 

SUPERSTITIOUS 

DAY-DREAMING 


MANNERISMS 


CLOUDING 

SENSE-  FALSIFICATIONS 


LOSS  OF  MEMORY 

CONFABULATION 

CIRCUMSTANTIALITY 

PERSEVERATION 

MONOTONY 


ST1MUL  ABILITY 

FLIGHT 

DIFFICULTY 


PERPLEXED 

APPREHENSIVE 

ANXIOUS 

OBSESSIONS 


HYSTERICAL  FEATURES 


IDEAS  OF  REFERENCE 
HALLUCINATIONS 
PARANOIC  TRENDS 
HEBEPHRENIC  FEATURES 
FEELING  OF  INFLUENCE 
AUTOCHTHONOUS  IDEAS 
SCATTERING  — 

NEOLOGISMS-  ' 

PHANTASIES 

ECSTASY 

WITHDRAWAL  OF  INTEREST 
PSEUDOSPONTANECUS  MOVEMENT 
STEREOTYPIES 
KATATONIC  FEATURES 


CHART  IV — Analysis  of  a case  showing  a paranoid  type  of 

reaction. 

needed,  but  the  illustration  of  the  method.  It  is  offered 
with  the  hope  of  securing  suggestions  and  criticisms.  Similar 
schemes  with  different  headings  might  well  serve  to  deter- 
mine the  selection  of  a form  which  could  become  standard- 
ized. 


128  Graphic  Representation  of  Personality  and  Psychosis 


ENDOWMENT 

VIGOR  or  EXPRESSION 
PiurniHi/  DOMINANCE 
INITIATIVE 
BODILY  RESISTANCE 


MOOD 


HELPFUL 


HARMFUL 


HAPPY 
SAD 

COLORLESS 
OSCILLATING 
NATIVE  INTELLIGENCE 


ADJUSTMENT 
PRIMITIVE  SENSUAL 


DOMESTIC 

SOCIAL 

PRACTICAL 

ARTISTIC 


HARMLESS  HOBBIES 

IRRITABLE 

OVERSCRUPULOUS 

EXPLOSIVE  AFFECTS 

HYPOCHONDRIA 
DRUG  ADDICTION 
SUSPICIOUS 


BASHFUL 

SUPERSTITIOUS 

DAY-DREAMING 


MANNERISMS 


CLOUDING 

SENSE-  FALSIFICATIONS 


LOSS  OF  MEMORY 

CONFABULATION 

CIRCUMSTANTIALITY 

PERSEVERATION 

MONOTONY 


STTMULABIUTY 

FLIGHT 

DIFFICULTY 


PERPLEXED 

apprehensive 

ANXIOUS 

OBSESSIONS 

HYSTERICAL  FEATURES 


IDEAS  OF  REFERENCE 
HALLUCINATIONS 
PARANOIC  TRENDS 
HEBEPHRENIC  FEATURES 
FEELING  OF  INFLUENCE 
AUTOCHTHONOUS  IDEAS 
SCATTERING 
NEOLOGISMS 
PHANTASIE6 
ECSTASY 

WITHDRAWAL  OF  INTEREST 
PSEUDOSPON7ANEDLTS  MOVEMENT 
STEREOTYPIES 
KAT ATONIC  FEATURES 


CHART  V — Analysis  of  a case  presenting  a complex  type 

reaction. 


H.  Douglas  Singer 


129 


ENDOWMENT 

. VIGOR  or  EXPRESSION 
FWrorv  DOMINANCE 

tncrttaT  INITIATIVE 

BODILY  RESISTANCE 


■ 


MOOD 


HAPPY 
SAD 

COLORLESS 
OSCILLATING 
NATIVE  INTELLIGENCE 


ADJUSTMENT 
PRIMITIVE  SENSUAL 


helpful 


DOMESTIC 

SOCIAL 

PRACTICAL 

ARTISTIC 


I 


T 

I 


HARMLESS  hobbies 

IRRITABLE 

OVERSC PUP ULCUS 

EXPLOSIVE  AFFECTS 

HYPOCHONDRIA 
DRUG  ADDICTION 
SUSPICIOUS 


HARMFUL 


BASHFUL 

SUPERSTITIOUS 

DAY-DREAMING 


MANNERISMS 


CLOUDING 

SENSE- FALSIFICATIONS 


LOSS  OF  MEMORY 
. CONFABULATION 
CIRCUMSTANTIALITY 
PERSEVERATION 
MONOTONY 


STIMUL  ABILITY 

FLIGHT 

DIFFICULTY 


PERPLEXED 

APPREHENSIVE 

ANXIOUS 


HYSTERICAL  FEATURES 


IDEAS  OF  REFERENCE 
HALLUCINATIONS 
PARANOIC  TRENDS 
HEBEPHRENIC  FEATURES 
FEELING  OF  INFLUENCE 
AUTOCHTHONOUS  IDEAS 
SCATTERING 
NEOLOGISMS 
PHANTA6IE6 
ECSTASY 

WITHDRAWAL  OF  INTEREST 
PSCUOOSPONTANEDUS  MOVEMENT 
STEREOTYPIES 
KATATONIC  FEATURES 


CHART  VI — Average  of  25  unselected  cases  of  general 
paralysis  of  the  insane. 


DISTINCTIVE  FEATURES  IN  PSYCHOLOGICAL 
TEST  MEASUREMENTS  MADE  UPON 
DEMENTIA  PRAECOX  AND  CHRONIC 
ALCOHOLIC  PATIENTS1 

BY  S.  L.  PRESSEY,  A.  M. 

Interne  in  Psychology,  Psychopathic  Hospital, 

Boston,  Mass. 

THUS  far  psychological  methods  of  measuring  in- 
telligence have  been  developed  almost  wholly 
according  to  the  needs  of  work  with  the  feeble- 
minded. However,  problems  suggesting  mental 
measurement  are  also  frequently  presented  by  psychotic 
cases.  A feeble-minded  basis  for  the  disease  is  often  sus- 
pected. Some  measurement  of  mental  deterioration  would 
in  other  instances  be  of  distinct  value.  Numerous  attempts 
to  employ  the  routine  tests  for  feeble-mindedness  in  dealing 
with  such  cases  have  proved  their  inadequacy;  it  seems 
clear  that  for  use  with  psychotic  cases  a group  of  tests 
especially  organized  for  the  purpose  is  necessary.  A study 
of  the  general  problem  of  mental  measurement  of  psychotic 
patients  was  therefore  proposed  to  the  writer  by  Dr.  R.  M 
Yerkes,  as  part  of  the  psychological  research  program  at  the 
Boston  Psychopathic  Hospital.  The  present  paper  is  a 
first  report  on  this  work. 

Such  a group  of  tests  must  evidently  be  adapted  to 
meet  a wide  variety  of  conditions.  The  problem  presented 
the  psychological  examiner  by  a psychotic  patient  may  be 
found  very  different  at  different  stages  of  the  disease. 
Different  mental  diseases  may  require  largely  different 
methods;  it  may  appear  that  wholly  different  groups  are 
needed  for  special  diseases  or  stages.  Or  the  same  disease 

■“Paper  presented  at  Conference  on  Methods  of  Psychological  Examining 
October  28,  1916.  Waverley,  Mass.,  being  Contribution  of  the  Massachusetts 
Commission  on  Mental  Diseases,  whole  number  182  (1917  .2).  The  previous  con- 
tribution, 167  (1917  .1)  was  by  R.  M.  Yerkes  and  C.  S.  Rossy,  entitled  “A  Point 
Scale  for  the  Measurement  of  Intelligence  in  Adolescent  and  Adult  Individuals, 
to  appear  in  the  Boston  Medical  & Surgical  Journal,  April,  1917. 

130 


S.  L.  Pressey 


I3i 

may  conceivably  be  discovered  to  affect  different  individuals 
in  varying  ways  to  such  an  extent  as  to  make  the  use  of  any 
closely  organized  routine  examination  impossible.  But  a 
mental  disease  also  shows  many  important  features  whose 
right  to  play  a part  in  the  determination  of  a mental  rating 
(supposed  to  take  account  only  of  intelligence)  could  very 
well  be  questioned.  These  features  are  in  fact  often  transi- 
tory, and  symptoms  merely  of  a particular  stage  of  the 
disease.  No  examination  can  of  course  be  made  unless  the 
patient  is  quiet  and  cooperative.  But  he  may  still  be 
negativistic,  may  be  too  absorbed  with  his  delusions  to  give 
adequate  attention  to  the  tests,  may  perhaps  be  hallucinated, 
may  be  in  an  emotional  state  which  prevents  satisfactory 
work.  Means  of  taking  account  of  such  factors  must  be 
found,  or  tests  used  which  are  relatively  little  affected  by 
them.  The  situation  is  extremely  complex,  and  as  yet 
little  analyzed  so  far  as  the  problems  of  the  psychological 
examiner  are  concerned.  Under  these  circumstances  any 
direct  attack  upon  either  of  the  two  questions  mentioned 
above,  of  previous  mental  level  and  of  present  mental  loss, 
was  clearly  impossible  in  the  first  handling  of  material.  A 
preliminary  study  to  give  a general  survey  and  orientation, 
and  discover  the  best  methods  of  approach,  was  necessary. 

The  work  here  reported  was  planned  as  such  a first 
sampling  of  materials  and  trial  of  methods.  The  cases  were 
examined  with  the  Point  Scale  plus  certain  supplementary 
tests  (mostly  of  the  Healy  group).  The  cue  as  to  method 
of  handling  data  was  taken  from  the  problem  which  at  once 
presents  itself  when,  in  practical  work,  such  a routine  exam- 
ination is  given  to  a group  of  psychotics.  A large  propor- 
tion grade  as  feeble-minded.  In  a given  case,  the  question 
immediately  arises  as  to  whether  the  low  grade  is  due  to  the 
mental  disease  or  to  primary  amentia.  The  present  study 
is  concerned  with  this  question.  A means  of  answer  should 
be  obtained  by  comparing  the  results  given  by  a group  of 
individuals  who  had  developed  to  the  adult  level  of  intelli- 
gence, but  now  because  of  mental  disease  grade  as  feeble- 
minded, with  results  from  individuals  of  like  mental  age 
known  to  be  cases  of  primary  amentia.  Such  a comparison 
might  bring  out  some  features  characteristic  of  the  psychotic 


132 


Features  in  Test  Measurements 


group,  and  suggest  means  by  which  still  more  distinctive 
results  might  be  obtained. 

The  problem  of  the  paper,  as  thus  set,  required  psychotic 
cases  grading  as  feeble-minded  and  presenting  histories 
indicative  of  the  previous  attainment  of  adult  intelligence. 
The  selection  was  finally  limited  to  examinations  yielding 
mental  ages  from  eight  through  twelve  years  by  the  Point 
Scale.  Illiterate  cases,  those  with  a language  handicap, 
also  some  whose  condition  at  the  time  of  examination  was 
such  as  to  make  its  validity  questionable,  were  excluded. 
The  elimination  of  certain  cases  whose  histories  suggested  a 
feeble-minded  basis  for  the  psychosis  would  also  have  been 
desirable  theoretically.  The  majority  of  these  had  already 
been  excluded  from  the  tables  by  the  requirement  that,  in 
spite  of  the  diseased  condition,  the  patient  must  grade  above 
eight  mentally,  and  by  the  rejection  of  illiterates.  No 
further  satisfactory  criteria  for  the  elimination  of  such  cases 
could  be  found.  The  tables  doubtless  include  a few  patients 
originally  subnormal.  But  this  can  not  do  more  than  render 
differences  less  apparent.  The  large  majority  of  the  histories 
give  indications  of  a previous  mentality  well  up  to  normal. 
As  a whole,  then,  the  cases  make  up  a group  which  had 
developed  clearly  above  a feeble-minded  level. 

Of  the  total  group,  fifty  had  been  diagnosed  as  dementia 
praecox.  Their  average  age  was  thirty,  the  ages  ranging 
from  fifteen  to  fifty-five — their  average  mental  age  was  10.5. 
Twenty-five  were  chronic  alcoholics.  This  sub-group  was 
too  small  to  have  much  significance  by  itself,  but  appeared 
of  decided  interest  for  purposes  of  comparison  with  results 
from  the  dementia  praecox  cases.  The  average  mental  age 
was  practically  the  same,  10.9.  But  the  average  chrono- 
logical age  was  twelve  years  more — forty-two;  the  range 
was  from  twenty-five  to  sixty-three  years.  More  important, 
however,  was  the  difference  in  time  of  examination  with 
relation  to  the  course  of  the  disease.  The  majority  of  the 
dementia  praecox  cases  at  the  Psychopathic  Hospital  appear 
there  at  the  time  of  first  onset  of  the  psychosis;  though  the 
disease  has  presumably  been  in  progress  for  a considerable 
period  previous  to  this,  its  actual  disintegrating  effect  upon 
the  mentality  has  only  recently  become  noticeable.  But 


5.  L.  Pressey 


133 


the  active  psychotic  symptoms  are  numerous  and  varied. 
The  patient  is  probably  deluded,  perhaps  hallucinated, 
shows  emotional  abnormalities.  With  the  chronic  alcoholic 
the  situation  is  largely  reversed.  He  is  not  brought  to  the 
Hospital  until  his  condition  has  gone  from  bad  to  worse  as 
the  result  of  years  of  dissipation.  The  number  of  active 
symptoms,  however,  is  much  less,  the  chief  evidence  of 
psychosis  being  the  gradual  deterioration.2  Any  agreement 
between  the  findings  on  the  two  groups  will  thus  be  of 
decided  interest.  It  would  suggest  that  the  problems  of 
test  measurement  may  not  be  so  different  with  the  different 
types  of  psychoses  as  at  first  would  appear  likely, — that 
largely  similar  methods  of  attack  might  then  be  used,  at 
least  in  the  first  handling  of  materials. 

Differential  features  in  the  results  given  by  these 
psychotic  cases  as  against  results  from  the  feeble-minded, 
were  sought  in  four  ways.  First,  the  average  psychotic 
performance  on  each  test  of  the  Scale  was  compared  with 
average  feeble-minded  performance.3  Second,  the  average 
psychotic  and  the  average  feeble-minded  showings  on  the 
scale  were  compared  with  the  average  normal.  Third,  the 
amount  of  scatter  about  their  mean  shown  by  one  group  of 
the  psychotics  was  compared  with  the  scatter  shown  by  an 
equal  number  of  feeble-minded  cases.  Fourth,  the  showing 
of  the  psychotic  patients  on  the  supplementary  tests  was 
compared  with  the  average  performance  on  these  tests. 

In  order  to  get  at  possible  distinctive  reactions  to  the 
separate  tests  of  the  Scale,  the  score  made  by  each  psychotic 
case  on  a given  test  was  compared  with  the  average  score 
made  by  a group  of  feeble-minded  cases  rating  at  the  same 
mental  age.  If  for  instance,  a dementia  praecox  patient 
making  a mental  age  of  11.8  on  the  Point  Scale  scored  five 
points  on  test  nineteen,  this  would  be  compared  with  the 
average  score — 2.6 — on  test  nineteen  made  by  defective 
cases  giving  a mental  age  of  11.8.  The  dementia  praecox 
is  then  given  plus  2.4  on  this  test.  And  the  algebraic  sum  of 

JOnly  cases  diagnosed  simply  as  chronic  alcoholism  were  used;  diagnoses  of 
alcoholic  hallucinosis,  alcoholic  delusional  insanity,  etc.,  were  excluded. 

3Work  done  by  Dr.  J.  N.  Curtis  on  two  hundred  cases  at  the  Waverley  School 
for  the  Feeble-Minded. 


134 


Features  in  Test  Measurements 


plus  and  minus  variations  credited  the  fifty  dementia  praecox 
patients  on  test  nineteen  shows  the  tendency  of  the  group  on 
this  test.  These  results,  expressed  as  per-cents  of  the 
average  feeble-minded  score,  which  the  psychotics  make  on 
each  test  of  the  Point  Scale,  are  presented  in  the  following 
table: 


UT~ 

TEST 

1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

Dem.  Prae. 

1.00 

1.02 

.98 

1.10  1 

1.05 

(1.21)5 

1.00 

.89 

.86 

1.02 

% bal.  + or  — 

— 

+24 

1— 

20  + 

36  + 

(4—) 

12+ 

8 + 

36— 

4+ 

Alcoholics 

1.00 

.93 

.97 

1.00 

1.04 

(1.15)5 

.86 

1.12 

.96 

1.04 

% bal.  + or  — 

— 

16— 

— 

4+ 

20  + 

(12+) 

60— 

28+ 

12— 

20  + 

TEST 

11 

12 

13 

14 

.15 

16 

17 

18 

19 

20 

Dem.  Prae. 

.96 

.99 

.83 

.95 

.98 

.52 

.88 

1.23 

1.55 

1.01 

% bal.  + or  — 

24- 

36  + 

8— 

26— 

20  + 

40— 

28— 

— 

38  + 

16— 

Alcoholics 

1.02 

.86 

.95 

1.04 

1.19 

.32 

1.30 

1.15 

1 87 

1.11 

% bal.  + or  — 

36  + 

12— 

— 

12— 

60  + 

84— 

52  + 

20— 

62  + 

12  + 

With  the  small  number  of  cases  used,  only  marked 
variations  can  be  considered  significant.  Variations  over 
fifteen  percent  should,  however,  be  well  out  of  the  range  of 
purely  chance  distribution;  all  such  variations  are  underlined. 
As  a rough  measure  of  the  constancy  of  the  tendencies  the 
balance  of  plus  and  minus  signs  is  used,  and  a balance  of 
more  than  thirty  percent  one  way  or  another  again  under- 
lined. 

The  interesting  features  of  the  results  are  the  surprising 
difficulty  (53%  and  32%  of  the  average  for  the  primary 

4The  tests  of  the  Point  Scale  are  as  follows;  (1)  chooses  prettier  of  three  pairs 
of  pictures;  (2)  sees  picture  lacks  arms,  nose,  etc.;  (3)  compares  lines  and  weights; 
(4)  memory  span  for  digits;  (5)  counts  backward  20-1;  (6)  memory  span,  sentences; 
(7)  Reaction  to  Binet  pictures;  (8)  arranges  weights  in  order;  (9)  compares  apple 
and  banana,  etc.;  (10)  defines  spoon,  chair,  etc.,  (11)  line  suggestion  test;  (12) 
copies  square  and  diamond;  (13)  free  association  for  three  minutes;  (13)  writes 
sentence  containing  Boston,  money,  river;  (15)  comprehends  questions — what  woul 
you  do  if  you  missed  your  train,  etc.;  (16)  draws  Binet  figures  from  memory;  (17) 
sees  absurdities;  (18)  puts  dissected  sentences  together;  (19)  defines  charity, 
obedience,  etc.;  (2o)completes  analogies — oyster  is  to  shell  as  banana  is  to — etc. 

6Due  largely  to  a change  in  scoring:  of  only  comparative  significance. 


S.  L.  Pressey 


135 


aments)  shown  by  both  groups  of  psychotics  in  test  16, 
drawing  the  Binet  figures  from  memory,  and  the  marked 
superiority  (1.55%  and  1.87%)  over  the  feeble-minded 


POINT  SCALE  TESTS 


Variation  from  scoremade  by  average  normal  of  the  same  mental  age  given  by 
groups: 


- feeble-minded; 

dementia  praecox; 

chronic  alcoholics. 


Test  

1 2 3 4 5 6 7 6 9 10  11  1 2 13  14  15  16  17  18  19  20 


Variations  given  as  per-cents  of  average  normal  score. 

(a)  due  largely  to  a change  in  methods  of  scoring,  of  only  comparative  signi- 
ficance. 

cases  in  test  19,  defining  abstract  words. | The  dementia 
praecox  show  a distinct,  though  less  striking  peculiarity  in 
their  slowness  of  free  association;  the  alcoholics  are  separated 

{It  is  interesting  to  note  that  this  test  is  (table  30,  p.  123  of  “A  Point  Scale 
for  Measuring  Mental  Ability”)  one  of  the  most  conclusive  in  its  indication  of  good 
mental  level  with  normal  children.  There  is  no  score  till  the  ninth  year,  and  the 
averages  then  run:  .9,  1.6,  1.9,  3.3,  3.9,  4.0,  4.0  for  the  years  nine  to  fifteen  in- 

clusive. Its  emergence  again,  in  a study  of  psychotics,  as  a test  of  special  diagnostic 
value  has  made  it  seem  worth  while  to  try  to  develop  it  further;  a special  supple- 
mentary test  of  this  nature  is  now  being  tried  out. 


136 


Features  in  Test  Measurements 


off  from  the  dementia  praecox  by  their  more  ready  response 
to  “comprehension  of  questions”  and  to  “absurdities.” 

The  second  question  taken  up,  was  as  to  whether  the 
psychotics  showed  consistent  differences,  as  compared  with 
the  feeble-minded,  in  their  variations  from  the  average 
normal  of  the  same  mental  age.6  The  data  has  been  handled 
as  before  except  that  the  average  normal  instead  of  the 
average  feeble-minded  score  is  taken  as  a basis.  And  the 
results  are  graphed  in  order  to  make  them  more  readily 
grasped  as  a whole.  Variations  over  fifteen  per  cent  are 
here  marked  off  by  the  two  double  lines. 

The  feeble-minded  cases  show  only  one  variation  over 
15%.  This  is  on  test  14  (making  a sentence  containing 
Boston,  money,  river);  their  score  is  7 3%  of  normal.  On 
the  other  hand,  the  dementia  praecox  give  five  such  varia- 
tions. They  score  77%  of  normal  on  test  9 (comparisons), 
71%  on  test  13  (free  association  for  three  minutes),  67%  on 
test  14,  54%  on  test  16  (drawing  Binet  figures  from  memory), 
1.38%  on  test  19  (definition  of  abstract  words).  The  al- 
coholics average  77%  on  test  13,  1.29%  on  test  15  (compre- 
hension of  questions),  32%  on  test  16,  1.25%  on  test  17 
(understanding  absurdities),  1.64%  on  test  19, — again  five 
variations  over  15%.  The  psychotics  thus  show  both  more 
frequent  and  greater  variations  from  the  average  normal  of 
the  same  mental  age  than  do  the  feeble-minded.'  Further- 
more, the  results  from  the  two  groups  of  psychotic  cases 
agree  surprisingly. 

So  far,  the  paper  has  dealt  with  the  average  tendencies 
of  the  two  groups.  These  averages  have  been  found  to  differ 
markedly  in  certain  respects  from  the  average  for  feeble- 
minded individuals  of  the  same  mental  age.  But  a greater 
variation  around  their  averages  might  also  be  expected  to 
characterize  the  psychotics,  due  to  different  stages  of  the 
disease  in  which  different  patients  might  be  at  the  time 
of  examination,  and  different  effects  which  it  might  have  on 
different  individuals  or  other  similar  causes.  Some  estimate 

6The  data  of  table  30  of  “A  Point  Scale  for  Measuring  Mental  Ability’’ 
were  here  used. 

TIt  will  be  observed  that  the  upper  end  of  the  Scale  is  the  differential 
portion.  The  first  twelve  tests  show  little  sensitiveness. 


S.  L.  Pressey 


137 


of  the  amount  of  such  scattering  appeared  worth  attempting. 
The  twenty-five  alcoholics  were,  therefore,  paired  each  with 
a primary  ament  whose  score  totalled  exactly  the  same 
number  of  points,  and  the  average  of  each  group,  for  each 
test  was  found.  The  mean  variation  of  each  group  from  its 
own  average  was  then  worked  out.  Due  probably  to  such 
causes  as  those  mentioned  above,  the  alcoholics  show  17% 
more  fluctuation  about  their  group  average  than  do  a 
comparable  group  of  feeble-minded  cases.8 

A fourth  attempt  to  distinguish  the  examinations  given 
by  the  psychotic  cases  was  made  by  a study  of  the  reactions 
to  certain  supplementary  tests.  These  were  for  the  most 
part,  as  has  been  said,  of  the  Healy  group.  Usually  not  all 
the  tests  were  given;  the  following  were,  however,  tried  often 
enough  to  make  the  results  interesting.9 

Picture  form  board  (foal  and  mare— Healy).  Dementia 
praecox  32  cases,  alcoholic  17.  Each  group  averaged  two 
more  moves  with  the  triangles.  The  dementia  praecox  also 
took  two  more  main  moves.  There  was  no  clear  difference 
in  time  taken  to  do  the  test. 

Construction  puzzle  A (Healy).  Dementia  praecox 
43  cases,  alcoholics  22.  The  psychotics  average  a move 
less,  but  take  15"  longer. 

Construction  puzzle  B (Healy).  Dementia  praecox 
41  cases,  alcoholics  20.  The  dementia  praecox  took  five 
more  moves,  30"  more;  the  alcoholics  two  more  moves,  i' 
longer. 

Apperception  picture  puzzle  (Healy).  Dementia  prae- 
cox 42  cases,  alcoholics  22.  The  psychotics  averaged  one 
less  correct  move;  the  dementia  praecox  took  30",  the 
alcoholics  1'  30"  more  time. 

8The  twenty-five  alcoholics  showed  a total  variation  from  average  normal  of  the 
same  mental  age  32%  greater  than  did  the  strictly  comparable  twenty-five  cases 
of  primary  amentia. 

The  distribution  of  the  scores  within  the  Scale  clearly  is  often  quite  as  im- 
portant as  the  mental  age  or  total  rating.  The  writer  would  like  to  see  all  reports 
of  Point  Scale  results  include  some  statement  of  such  “irregularity.”  .We  might 
expect  the  report  on  a feeble-minded  case  to  read,  say  “Mental  age  11.8,  irregularity 
12  points,”  where  the  report  on  an  alcoholic  would  be  “Mental  age  11.8,  irregularity 
18  points.”  But  of  course  there  are,  at  present,  no  data  for  the  interpretation  of 
such  findings.  The  subject  of  distribution  of  score  within  the  examination  has 
certainly  not  received  the  attention  it  deserves. 

9The  comparisons  are  with  average  performance  for  the  same  mental  age,  as 
given  in  norms  for  these  tests  recently  worked  out  at  the  Hospital. 


138 


Features  in  Test  Measurements 


Visual  Verbal  memory  passage  (Healy).  Dementia 
praecox  28  cases,  alcoholics  15.  The  psychotics  averaged 
two  less  details,  took  15"  less. 

Auditory  verbal  memory  passage  (Healy).  Dementia 
praecox  32  cases,  alcoholics  19.  The  dementia  praecox 
give  back  two  less  details,  the  alcoholics  one  less.  Time 
showed  no  clear  variation. 

Learning  test — arbitrary  associations  (Healy).  De- 
mentia praecox  32  cases,  alcoholics  19.  The  psychotics 
average  two  less  details. 

The  special  contribution  of  the  supplementary  tests  to 
the  examination  is  made  by  the  tests  of  procedure  (the 
picture  form  board  and  construction  puzzles — also,  if  so  used 
the  apperception  picture  puzzle.)  The  tests  of  the  Scale 
score  merely  end  product,  not  method.  The  peculiarity 
of  method — or  lack  of  method — shown  by  the  psychotics 
on  these  procedure  tests  was  often  the  most  distinctive 
feature  of  the  examination.  This  is  not  sufficiently  described 
by  those  elements  (time  and  number  of  moves)  for  which 
norms  are  available.  Clearly  illogical  moves,  impossible 
moves,  obvious  repetitions,  exceptionally  fast  or  slow  ways 
of  working,  frequent  failures,  are  characteristic  of  psychotic 
attempts  at  these  tests.  Patients  grading  relatively  high 
on  the  Scale  frequently  give  a performance  on  these  puzzles 
which  can  be  matched  only  among  the  low  grades  of  the 
feeble-minded. 

The  paper  may  be  very  briefly  summarized.  The 
results  given  by  a group  of  psychotic  cases  on  certain  psycho- 
logical tests  differed  from  those  given  by  feeble-minded 
cases  grading  at  the  same  “mental  age”  in  the  following 
four  ways: 

(1.)  The  reaction  to  certain  tests  of  the  Scale  was 
strikingly  different.  Ability  to  define  abstract  words  was 
greater;  capacity  to  grasp,  retain,  and  reproduce  somewhat 
unfamiliar  memory  material  was  less. 

(2.)  There  was  on  the  tests  of  the  Scale  a greater  con- 
sistent total  variation  from  the  average  normal  of  the  same 
mental  age. 


S.  L.  Pressey 


139 


(3.)  There  was  more  individual  variation  from  the 
average  for  the  group. 

(4.)  There  was  a distinctive  reaction  to  tests  of  pro- 
cedure. 

These  results  are  based  on  too  inadequate  data  to  be  of 
more  than  the  most  general  significance;  a later  report  is- 
planned  to  include  the  large  number  of  psychotic  cases  being 
examined  with  the  same  tests  during  the  present  year.  In 
any  event,  the  tests  which  appear  differential  are  all  too 
small,  and  too  subject  to  the  chance  error  of  the  examination,, 
to  allow  of  any  conclusions  being  drawn  from  them  in  par- 
ticular cases.  But  as  suggesting  lines  of  work  which  might 
lead  to  tests  more  adequate  for  such  practical  purposes,  they 
would  seem  of  definite  value.  They  suggest  that  the  dis- 
tinction between  true  primary  aments  and  those  cases 
grading  low  because  of  mental  disease  might  be  made  more 
definite,  (a)  by  developing  tests  (analogous  to  test  19,  defi- 
nition of  abstract  words)  not  requiring  new  adjustment,  but 
rather  drawing  upon  previous  acquisitions  of  an  adult  level; 
(b)  by  setting  over  against  these,  more  satisfactory  tests  of 
attention  and  of  learning;  (c)  by  using  more  tests  that  score 
procedure  as  well  as  end  product. 

Work  along  each  of  these  three  lines  is  now  being  carried 
on  at  this  Hospital. 


REVIEWS 


nervous  and  mental  diseases.  By  Hugh  T.  Patrick , M.  D., 
and  Peter  Bassoe,  M.  D.,  with  the  collaboration  of  Lewis  J . Pollock, 
M.  D.  Volume  X of  the  Practical  Medicine  Series,  1916,  under  the 
general  editorial  charge  of  Charles  L.  Mix,  A.  M.,  M.  D.,  Chicago. 
The  Year  Book  Publishrs.  Price  $1.35. 

This  is  the  latest  number  of  this  yearly  publication,  which  is  a 
review  of  selected  articles  on  selected  subjects  in  the  field  of 
neurology  and  psychiatry  for  the  year  1916.  There  are  abstracts 
of  articles  dealing  with  a wide  range  of  subjects,  including  symp- 
tomatology, the  neuroses  (epilepsy,  hysteria,  chorea,  and  other 
neuroses),  the  cerebrospinal  fluid  and  diseases  of  the  meninges 
(including  cerebrospinal  meningitis),  the  syphilitic  diseases  of  the 
nervous  system,  diseases  of  the  brain  (including  vascular  diseases, 
miscellaneous  brain  disorders,  tumors  and  abscess  of  the  brain, 
the  basal  ganglia,  hypophysis,  pineal  gland  and  cerebellum), 
diseases  of  the  spinal  cord  and  of  the  peripheral  nerves,  and  other 
topics  of  interest  in  pure  neurology,  and  of  various  diseases  in  the 
field  of  psychiatry. 

The  authors  have  shown  good  judgment  in  the  selection  of 
the  material  used  for  abstract  purposes,  and  in  briefly  presenting 
the  gist  of  the  articles  chosen  for  review.  Although  this  volume 
has  been  prepared  primarily  with  the  needs  of  the  average  general 
practitioner  of  medicine  in  mind,  nevertheless  the  subjects  given 
the  most  prominent  consideration  are  just  those  which  are  of  the 
greatest  interest  to  the  specialist  in  the  field  of  neurology  and 
psychiatry. 

Meyer  Solomon. 

LEONARDO  DA  VINCI.  A PSYCHOSEXUAL  STUDY  OF  AN  IN- 
FANTILE reminiscence.  By  Professor  Dr.  Sigmund  Freud,  LL.  D. 
( University  of  Vienna).  Translated  by  A.  A.  Brill,  Ph.  B.,  M.  D., 
Lecturer  in  Psychoanalysis  and  Abnormal  Psychology,  New  York 
University,  New  York.  Moffat,  Yard  & Company,  1916.  Price, 
$1.25  net. 

This  is  one  of  the  works  of  Freud  which  has  recently  been 
translated  into  English  by  his  faithful  translator,  Brill.  It  is  a 
truly  remarkable  document.  In  it  Freud  has  boldly  attempted 
to  enter  the  field  of  biography  from  the  standpoint  of  psychoanaly- 
tic interpretation,  and  has  chosen  as  his  victim  the  great  Leonardo. 
Freud  does  not  mince  words  in  this  discussion  but  unearths  the 
.driving  forces  which  he  deems  responsible  for  the  peculiarities  of 

I40 


Reviews 


141 

character  which  have  been  unearthed  or  discovered  by  da  Vinci’s 
biographers.  Naturally  da  Vinci’s  career  is  scrutinized  with  an 
all-powerful  eye  (psychoanalytically),  various  interpretations  are 
given  for  certain  trends  in  the  painter’s  life  and  works,  even  for 
the  much-heralded  Mona  Lisa  smile,  and,  with  the  help  of  what  is 
called  the  infantile  vulture  memory  or  phantasy  of  Leonardo,  plus 
the  addition  of  other  points  in  his  life,  ingenuously  interpreted 
and  worked  into  the  general  scheme  of  things  as  he  would  have  it 
(so  it  appears  to  me),  Freud  has  found  little  trouble  in  reducing 
the  whole  business  to  the  usual  sexuality,  especially  of  the  incest 
and  homosexual  types. 

Freud  has  interpreted  aright  the  impression  a reading  or 
study  of  this  work  will  have  on  the  average  person,  when  he  states 
that  one  may  conclude  that  he  (Freud)  has  after  all  written  nothing 
more  than  a psychoanalytic  romance.  And  so,  indeed,  it  appears 
to  me.  For,  truly,  it  is  difficult  for  me  to  believe  that  Freud  really 
believes  that  what  he  has  written  is  the  actual,  scientific  truth. 
It  makes  one  almost  feel  that  Freud  was  romancing,  was  having 
a little  fun  with  himself  and  da  Vinci,  was  seeing  just  how  close- 
fitting  a story  he  could  write  in  applying  his  theories  to  the  great 
painter. 

Of  course  Freud’s  efforts  are  not  scientific.  He  says  so  and 
so  is  true,  and  that  is  all  there  is  to  it.  Naturally  he  does  support 
his  views  by  a few  facts  here  and  there,  culled  with  an  eye  to  its 
fitting  in  some  way  or  other  into  the  romance  which  he  has  built 
up  about  the  life  of  a great  man,  and  so  ingenuously  planned  and 
worked  out,  that  one  really  marvels  at  the  peculiar  working  of  the 
remarkable  mind  of  Freud — at  his  wonderful,  though  too  oft 
uncritical  imagination. 

To  be  sure,  all.  readers,  whether  believers,  non-believers  or 
partial  believers  in  Freud,  will  want  to  read  this  production  from 
his  pen.  All  will  find  it  of  interest,  especially  if  one  views  it  as 
the  remarkable  romance  produced  by  the  remarkable  mind  of 
Sigmund  Freud, 

Meyer  Solomon. 

what  is  psychoanalysis?  By  Isador  H.  Coriat,  M.  D., 
New  York.  Moffat,  Yard  & Company,  1917.  75  cents  net.  Pp 

127. 

This  is  a sort  of  quizz  compend  on  psychoanalysis.  It  con- 
sists of  a series  of  questions  and  answers  pertaining  to  psycho- 
analysis. It  seems  to  have  been  written  primarily  for  non-medical 
readers.  The  questions  and  answers  are  short  and  to  the  point. 
The  author  adopts  a strictly  orthodoxly  Freudian  standpoint 
throughout.  This  means,  of  course,  that  many  of  us  cannot 
agree  with  many  of  the  statements  made  in  this  work. 

Meyer  Solomon. 


NOTES 


REPORT  OF  COMMITTEE  OF  THE  NEW  YORK 
PSYCHIATRICAL  SOCIETY  ON  THE  ACTIVITIES  OF 
“CLINICAL  PSYCHOLOGISTS” 

At  a meeting  of  the  New  York  Psychiatrical  Society 
held  December  6,  1916,  a committee  was  appointed  to  in- 
quire into  the  activities  of  psychologists  and  more  particular- 
ly of  those  who  have  termed  themselves  “clinical  psychol- 
ogists ” in  relation  to  the  diagnosis  and  treatment  of  abnormal 
mental  conditions.  This  committee  desires  to  make  the 
following  report. 

We  have  been  greatly  impressed  by  the  earnestness  and 
success  with  which  psychologists  are  endeavoring  to  make 
their  science  serviceable  in  dealing  with  the  practical  affairs 
of  every-day  life.  We  wish  to  record  our  belief  in  the  wide 
usefulness  of  the  application  of  psychological  knowledge 
and  of  the  findings  of  certain  psychological  tests  in  such 
fields  as  the  modification  of  educational  methods  with 
reference  to  individual  differences,  the  vocational  problems 
presented  in  various  special  industrial  operations,  the 
development  of  scientific  methods  in  advertising,  salesmen- 
ship  and  other  means  of  business  appeal  and  in  the  investiga- 
tion of  such  special  problems  as  the  relation  of  environ- 
mental factors  to  the  quality  and  quantity  of  the  output  of 
the  individual.  We  feel  that  the  results  to  be  attained 
in  these  fields  fully  justify  the  belief  that  the  widening  of 
the  scope  and  application  of  psychological  knowledge  will 
make  psychology  one  of  the  most  useful  of  the  social  sciences 
instead  of  a narrow  field  for  study  and  research  with  but 
little  actual  contact  with  the  practical  problem  of  life. 

We  have  observed  with  much  distrust,  however,  the 
growing  tendency  of  some  psychologists,  most  often,  un- 
fortunately, those  with  the  least  amount  of  scientific  train- 
ing, to  deal  with  the  problem  of  diagnosis,  treatment,  social 
management  and  institutional  disposal  of  persons  suffering 


142 


Notes 


H3 


from  abnormal  mental  conditions.  We  recognize  the  great 
value  of  mental  tests  in  determining  many  questions  which 
arise  in  dealing  with  such  patients  but  we  have  observed 
that  most  of  such  work  which  is  being  done  by  psychologists 
and  particularly  by  persons  whose  training  in  psychology  is 
confined  entirely  to  learning  how  to  apply  a few  sets  of  these 
tests,  is  carried  on  in  schools,  courts,  correctional  institu- 
tions and  so-called  “psychological  clinics,”  quite  inde- 
pendently of  medically  trained  workers  who  are  competent 
to  deal  with  questions  involving  the  whole  mental  and 
physical  life  of  the  individual. 

We  believe  that  the  scientific  value  of  work  done  under 
such  conditions  is  much  less  than  when  carried  on  in  close 
co-operation  with  that  of  physicians  and  that  serious  dis- 
advantages to  patients  suffering  from  mental  disorders  and 
to  the  community  are  likely  to  result  and,  in  many  instances 
which  have  come  to  our  attention,  have  resulted.  This 
is  true  especially  when  the  mental  condition  of  the  patients 
examined  involves  questions  of  diagnosis,  loss  of  liberty  or 
educational  issues  more  serious  than  redistribution  of 
pupils  or  rearrangement  of  courses  of  study.  In  spite  of 
these  facts  two  States  have  enacted  laws  permitting  judges 
to  commit  mentally  defective  persons  to  institutions  upon 
the  so-called  expert  testimony  of  “clinical  psychologists” 
regarding  the  abnormal  mental  conditions  from  which  the 
patients  are  alleged  to  suffer.  We  believe  that  the  examina- 
tion upon  which  a sick  person  is  involuntarily  committed  to 
permanent  institutional  custody  is  one  of  the  most  serious 
responsibilities  assumed  by  physicians  and  that  in  no  cases 
whatever  should  it  be  entrusted  to  persons  without  training 
enabling  them  to  take  into  consideration  all  the  medical 
factors  involved.  The  same  is  true  of  mental  examinations 
of  juvenile  delinquents  and  criminals  whose  whole  careers 
depend,  in  many  cases,  upon  the  determination  of  their 
mental  condition. 

We  desire  to  make  the  following  specific  recommenda- 
tions : — 

I.  We  recommend  that  the  New  York  Psychiatrical 
Society  affirm  the  general  principle  that  the  sick,  whether  in 
mind  or  body,  should  be  cared  for  only  by  those  with  medical 


I 


144 


Notes 


training  who  are  authorized  by  the  State  to  assume  the 
responsibility  of  diagnosis  and  treatment. 

2.  We  recommend  that  the  Society  express  its  dis- 
approval and  urge  upon  thoughtful  psychologists  and  the 
medical  profession  in  general  an  expression  of  disapproval 
of  the  application  of  psychology  to  responsible  clinical  work 
except  when  made  by  or  under  the  direct  supervision  of 
physicians  qualified  to  deal  with  abnormal  mental  conditions. 

3.  We  recommend  that  the  Society  disapprove  of 
psychologists  (or  of  those  who  claim  to  be  psychologists  as 
a result  of  their  ability  to  apply  any  set  of  psychological 
tests)  undertaking  to  pass  judgment  upon  the  mental 
condition  of  sick,  defective  or  otherwise  abnormal  persons 
when  such  findings  involve  questions  of  diagnosis,  or  affect 
the  future  care  and  career  of  such  persons. 

Charles  L.  Dana,  Chairman. 

Adolf  Meyer, 

Thomas  W.  Salmon. 


BOOKS  RECEIVED 

Psychic  Phenomena  Science  and  Immortality.  By  Henry 
Frank.  Sherman  French  & Co.,  Boston.  2nd  Ed.  Pp.  556. 
$2.50  net. 

Eighth  and  Ninth  Annual  Report  of  the  Municipal  Court  of 
Chicago.  December,  1913  to  December,  1915  inclusive.  Pp.  153. 

A Study  of  Perseverance  Reactions  in  Primates  and  Rodents. 
By  G.  V.  Hamilton.  Henry  Holt  & Co.  Pp.  IV  and  65.  $.75. 

The  History  of  the  Psychoanalytic  Movement.  By  Prof. 
Dr.  Sigmund  Freud.  Nervous  and  Mental  Diseases  Monograph 
Series,  No.  25.  $.60. 

The  Mentality  of  the  Criminal  Woman.  By  Jean  V eidensall. 
Warwick  & York.  Pp.  XX  and  332.  ^i. 75- 

Study  of  Organ  Inferiority  and  its  Psychical  Compensation. 
By  Dr.  Alfred  Adler.  Trans,  by  Dr.  Smith  Ely  Jelliffe.  Nervous 
and  Mental  Diseases  Monograph  Series  No.  24.  Pp.  86.  $1.50. 

Mental  Conflicts  and  Misconduct.  By  William  Healy.  Little 
Brown  & Co.  Pp.  XI  and  330.  $2.50  net. 

The  Psychology  of  Special  Abilities  and  Disabilities.  By 
Augusta  F.  Bronner.  Little  Brown  & Co.  Pp.  VI  and  269. 
$1.75  net. 

Man’s  LTnconscious  Conflict.  By  Wilfred  Lay.  Dodd  Mead 
& Co.  Pp.  VI  and  318.  $1.50  net. 


THE  JOURNAL  OF 
ABNORMAL  PSYCHOLOGY 


VOL.  XII  AUGUST,  1917  NUMBER  3 


ORIGINAL  ARTICLES 

SYMPOSIUM 

THE  THEORIES  OF  FREUD,  JUNG  AND  ADLER* 
I.  The  Work  of  Sigmund  Freud 

BY  JAMES  J.  PUTNAM 

WHAT  are  the  features  of  the  work  of  Sigmund 
Freud1, — that  is,  of  the  psychoanalytic  movement, 
- — which  will  make  it  of  enduring  value;  and  what 
are  its  weaknesses  and  false  aims?  Finally,  what 
justification  was  there  for  the  defection  of  Adler  and  of 
Jung, — events  which  must  be  rated  as  of  marked  signifi- 
cance? 

The  present  seems  a fitting  time  for  making  these 
inquiries,  for  the  psychoanalytic  movement  has  been  sub- 
jected to  severe  criticism  for  many  years,  and  yet  is  slowly, 
but  steadily,  attracting  more  attention,  not  only  from  physi- 
cians and  from  patients,  but  also  froju  psychologists. 

Its  elements  of  strength,  which  have  secured  for  it  a 
lasting  place,  are,  first,  that  it  has  demonstrated  afresh, 
from  a relatively  new  standpoint  and  with  a marvellous 

^Presented  at  the  Eighth  Annual  Meeting  of  the  American  Psychopatho- 
logical  Association,  Boston,  Mass.,  May  24,  1917. 

JFor  brevity’s  sake,  I have  made  no  attempt,  in  this  short  communication) 
to  assign  to  the  several  members  of  the  able  group  of  men  who  have  worked  hand 
in  hand  with  Freud,  the  recognition  which  is  their  due.  I trust  that  this  omission 
will  be  overlooked  and  its  cause  appreciated. 

Copyright  1917  by  Richard  G.  Badger.  All  Rights  Reserved. 

MS 


146 


The  Work  of  Sigmund  Freud 


fullness  of  illustration,  the  importance  of  studying  men’s 
unconscious,  or  unacknowledged  motives,  and  impulses  to 
thought  and  action,  and,  next,  that  it  has  described  an  ex- 
traordinarily effective  method  for  doing  this,  which  is 
practically  new. 

When  one  considers  all  that  has  been  accomplished  by 
Freud  and  by  his  colleagues,  in  the  course  of  the  researches 
that  have  led  to  these  results; — the  light  that  has  been 
thrown  upon  the  meaning  of  dreams,  of  the  symptoms  of 
neurotic  illnesses  and  so,  virtually,  of  neurotic  illness  itself, 
of  personal  and  social  customs  and  institutions,  both  of 
primitive  and  civilized  men  and  races  of  men;  and  when  one 
considers  the  explanations — important  even  though  partial — 
through  which  Freud  has  sought  to  account  for  men’s 
tendency  to  express  themselves  in  poetry  and  art  and  philo- 
sophy and  religion,  it  excites  no  wonder  that  this  great 
movement  is  steadily  attracting  more  and  more  attention, 
and  from  unexpected  quarters. 

Who  would  have  dreamed,  a decade  or  more  ago,  that 
to-day  college  professors  would  be  teaching  Freud’s  doctrines 
to  students  of  both  sexes,  scientific  men  turning  to  them  for 
light  on  the  nature  of  the  instincts,  and  educators  for  hints 
on  the  training  of  the  young? 

These  phenomena  do  not  indicate  much  of  a change  of 
heart  on  the  part  of  parly  critics,  it  is  true,  for  prejudices  die 
hard;  but  they  do  indicate  two  significant  facts.  The  first 
is  that  the  task  to  which  Freud  found  himself  committed, — 
namely,  the  study  of  the  thoughts,  feelings,  and  motives  of 
which  men  are  unconscious  yet  which  strongly  and  strangely 
influence  their  moods  and  conduct, — is  one2  that  all  thought- 
ful men  must  and  will  study. 

The  next  most  noteworthy  fact  is  that,  in  dealing  with 
this  task  Freud  showed,  not  only  a remarkable  ability  and 
power  of  insight  but  a still  more  remarkable  fearlessness,  a 
tireless  energy  in  seeking  evidence,  and  an  unsurpassed 
fidelity  in  observation.  This  is,  indeed,  one  of  the  cases 
where  it  is  impossible  to  consider  a man’s  work  without 
taking  his  personality  into  account,  and  Freud’s  personality 
was  such  that  up  to  a certain  point  his  testimony  is  as  re- 

zConsider  the  hold  which  novels  and  dramas  have  upon  everyone. 


James  J.  Putnam 


H7 


liable  as  the  wax  impression  of  a coin. 

But  every  man  has  his  weaknesses  and  limitations,  and 
in  Freud’s  case  these  were  shown  in  the  fact  that  while  he 
became  exceedingly  adept  in  recognizing  certain  influences, 
he  failed,  mainly,  though,  I think,  not  wholly,  because  his 
attention  was  thus  engrossed,  to  take  sufficient  note  of  others 
that  likewise  were  at  play.  For  a time  this  made  no  obvious 
difference.  He  has  never  pretended  to  do  more  than  to 
demonstrate  the  presence  of  one  group  of  repressed  motives 
(the  sexual  group);  or,  rather,  to  bring  to  the  surface  re- 
pressed thoughts  of  all  sorts,  but  in  the  belief  that  the  sex 
classification  was  the  best.  This  portion  of  the  work  has 
given  rise  to  bitter  criticisms,  which  were  largely  based 
on  prejudice  and  need  not  be  considered  here.  After  a time, 
however,  when,  following  a sort  of  logical  destiny,  he  was 
led  to  apply  his  explanations  to  the  whole  range  of  human 
life,  new  obligations  were  involved  and  new  sorts  of  criticism 
came  to  view.  These  were  not  wholly  dictated,  like  the 
earlier  ones,  by  narrow  prejudice,  based  on  the  very  repres- 
sions that  he  sought  to  study,  but  on  the  fact  that  the  type 
of  mind  of  which  his  is  an  example  is  not  the  only  sort  that 
is  useful  even  for  purposes  of  scientific  investigation;  nor  is 
the  method  which  he  followed  the  only  suitable  one  for 
the  study  of  human  life. 

The  breaking  away  of  Adler  and  of  Jung  are,  I think, 
partly  to  be  explained  on  such  grounds  as  these,  though  it 
was  partly  due,  likewise,  I believe,  to  a misconception  of 
their  scientific  duty,— a misconception  which  led  them  to 
reject  without  sufficient  reason,  formulations  of  Freud’s 
which  were  of  permanent  value. 

It  is,  however,  true,  as  I believe,  that  Freud’s  strong 
accentuation  of  the  sex  motive,  and  of  the  merits  of  the  sex 
mode  of  classification,  although  dictated,  no  doubt,  by  an 
instinctive  feeling  that,  otherwise,  the  goal  sought — pri- 
marily the  therapeutic  goal — would  not  be  won,  did,  never- 
theless, prevent  him  from  adequately  filling  the  position 
of  judicial  student  of  human  motives  as  a whole,  that 
circumstances  almost  forced  him  to  assume. 

There  are  empirical  grounds  for  this  criticism  and  also 
scientific,  or  philosophic  grounds. 


1 48 


The  Work  of  Sigmund  Freud 


The  arguments  brought  forward,  for  example,  by 
Josiah  Royce  in  almost  all  his  recent  books,3  by  Trotter,4  by 
Coe,5  by  Stanley  Hall,6  and  others,  while  they  do  not  in  the 
least  impugn  the  value  of  Freud’s  arguments  ad  hoc , i.  e., 
as  contributions  of  immense  importance  to  the  subject  of 
sex-motivation,  do  emphasize,  in  their  turn,  social  motives 
other  than  sexual,  and  not  to  be  classed  as  sexual  without 
some  forcing,  which  one  could  wish  that  Freud  had  studied. 
Similar  comments  can  be  made  with  regard  to  the  effects  of 
his  rigid  acceptance  of  the  “scientific”  method  in  his  studies. 

One  may  succeed  in  showing  that  the  motives  of  a given 
philosopher,  a poet  or  adherent  of  religion,  are  permeated  by 
sensual  longings  of  infantile  origin;  and  one  may  then  go  to 
work,  if  one  will,  to  pick  to  pieces  the  rational  postulates  on 
which  a given  philosophy  or  religion  rests  its  claims.  Still, 
something  will  remain  that  the  mind  feels  to  be  of  vast 
importance,  and  for  which  “sublimation,”  as  usually  defined, 
does  not  adequately  account.  The  grown  man  recognizes 
motives  which  are  foreign  to  the  child,  or  to  nature,  but 
which,  on  monistic  grounds,  one  must  assume  to  have  been 
represented  there,  in  some  fashion. 

Freud’s  own  arguments  show  this.  He  is  avowedly  a 
scientific  monist,  and,  properly  speaking,  should  classify 
himself  with  the  “realists”  or  “behaviorists”  of  the  present 
day,  who  are,  virtually,  materialists.  But  science,  physics, 
chemistry  and  mechanics  know  no  “emotion,”  in  the  best 
human  sense,  and  even  the  James-Lange  theory,  although  it 
may  explain  almost  the  whole  mystery,  still  leaves  something 
unexplained. 

Professor  Holt'  praises  Freud’s  formulations  and,  with 
great  justice,  adopts  his  views  about  the  “wish”  as  the 
corner-stone  of  his  psychology.  But  Holt’s  “wish,”  like 
James’s  “emotion,”  leaves  one  cold,  while  the  “wish” 
in  Freud’s  sense  is  anything  but  cold.  A “something, 
undiscoverable  by  reason,  seems  left  out  when  one  accepts 
the  realistic  scheme  as  binding,  and  Freud  was  quick  to  see 

3Cf.  The  Philosophy  of  Loyalty,  for  ex. 

4The  Instinct  of  the  Herd,  in  Peace  and  War. 

5 The  Psychology  of  Religion. 

6Auger.  Jr.  of  Abn.  Psychol. 

7E.  B.  Holt:  The  Freudian  Wish. 


J ames  J.  Putnam 


149 


and  reprobate  this  tendency  when  it  came  to  estimating  the 
value  of  Adler’s  conception  of  the  nature  of  human  motives, 
as  he  does  in  his  history  of  the  psychoanalytic  movement.8 
Adler,  as  Freud  points  out,  in  throwing  so  much  emphasis 
upon  aggression,  in  his  analysis  of  motives,  leaves  no  room 
for  love.  But  it  is  hard  to  see  how  Freud,  if  he  would  be  a 
strictly  logical  follower  of  the  scientific  method,  can  bring  in 
love.  Unless  one  assumes  that  the  essence  of  love,  in  the 
most  spiritual  sense,  is  in  some  way,  represented  even  in  the 
physical  world,  then  it  cannot  get  in  at  all,  and  it  becomes 
necessary  to  accept  a building,  the  base  of  which  is  not 
broad  enough  to  support  the  superstructure. 

Some  of  these  points  may  now  be  taken  up  for  further 
study,  and  I would  say,  to  begin  with,  that  Freud’s  person- 
ality presents  itself  under  several  different  aspects,  which 
may  be  defined  as  those  of  the  clinician,  the  scientific  (psy- 
chologic) student,  the  student  and  conscientious  member  of 
society,  and  finally  (little  as  he  would  be  inclined  to  admit 
the  fact),  of  the  philosophic  thinker,  seeking  to  generalize 
his  conclusions  and  to  state  them  in  universal  terms. 

These  phases  of  Freud’s  thought  are  not  all,  as  I have 
said,  of  equal  value. 

As  detector  of  unacknowledged  motives  and  definer  of 
methods  for  detecting  them;  as  analyzer  of  the  personal  and 
social  situations  in  which  these  hidden  motives  play  their 
part  [interpretation  of  dreams,  wit,  conduct,  tabus,  etc.]; 
above  all,  as  founder  of  the  “free  association”  method,  he  is 
without  a rival.  If,  however,  one  looks  to  him  for  broad  and 
balanced  views  of  life  in  all  its  manifold  aspects,  and  for  a 
judicial-minded  interpretation  of  men’s  acts  and  thoughts 
under  conditions  where  many  motives — conscious  as  well  as 
unconscious,  and  both  conscious  and  unconscious  in  varying 
degrees — come  into  play,  one  is  doomed  to  partial  disappoint- 
ment: his  job  is  of  a more  specialized  sort.  As  a philosopher1 
he  is  weak.  On  the  whole,  he  stands  out  as  a courageous, 
unflinching,  pioneer-investigator  and  a man  of  genius; — and 
it  should  be  recognized  that  where  he  is  weak  he  has  never 

8 Sigmund  Freud:  Zur  Geschichte  der  psychoanalytisthen  Bewegung.(Now 
to  be  had  in  English.) 


The  Work  of  Sigmund  Freud 


150 

claimed  to  be  strong.9  Had  he  not  been  so  daring,  so  sin- 
cere, so  faithful,  and,  withal,  so  much  of  a sleuth-hound  as 
he  was  (in  a good  sense  and  in  the  interests  of  knowledge),  the 
science  of  psychology  would  still  be  without  its  best  impulse 
to  real  growth  and  practical  utility;  ancf  psycho-neuro- 
logical therapeutists,  ignorant  of  a large  portion  of  the  forces 
which  they  aspire  to  manipulate,  would  still  be  fumbling  in 
the  dark  with  powerful,  two-edged  weapons,  in  the  use  of 
which  they  could  obtain  no  adequate,  systematic  training. 
On  the  other  hand,  had  Freud’s  splendid  analytic  powers 
been  supplemented  by  an  equally  powerful  capacity  and 
impulse  to  make  himself  acquainted  with  all  the  forces 
shaping  human  lives,  at  their  best,  in  all  their  fullness  and 
richness,  before  he  studied  them  in  their  narrowness  and 
weakness  and  in  the  imperfect  stages  of  their  development, 
and  had  he — equipped  as  he  is  with  strong  intelligence — 
been  moved  to  recognize  the  limitations  of  the  scientific 
method,  and  to  see  that,  just  as  the  language  of  signs  and 
feeling  transcends  that  of  logical  concepi-building  at  one 
end  of  the  scale,  so  the  language  of  trained  and  illumined 
intuition  transcends  it  at  the  other  end;  had  he,  in  short, 
been  a man  of  more  idealistic  type,  then  psychoanalysis — 
if  it  had  come  into  existence  at  all — might  perhaps  have  been 
kept  free  from  what  even  certain  fair-minded  men  have 
considered  as  one-sidedness.  But  would  it  hare  come  into 
existence  at  all?  Probably  not.  For  although  it  is,  I believe, 
easily  conceivable  that  a man  of  philosophic,  idealistic,  or 
religious  tendencies  and  training  should  be  able,  if  intelli- 
gent, to  make  himself  a useful  and  even  a progressive  and 
orthodox  psychoanalyst,  yet  it  is  exceedingly  improbable 
that  such  a man  would  have  become  a psycho-analytic 
pioneer  of  a thoroughgoing  type.  It  is  hard  to  believe, 
in  short,  that  psychoanalysis  could  have  had  a development 

9Freud  has  disclaimed  interest  in  the  philosophic  mode  of  approach,  or  famili- 
arity with  its  methods  and  arguments;  it  is  the  “libido”  of  the  philosopher  that, 
alone,  he  has  felt  concerned  to  study,  and  the  philosophic  attitude  has  seemed  to 
him  a mode  of  seeking  compensation,  like  (in  his  estimation)  the  religious  attitude. 
This  mode  of  looking  at  the  matter  has  its  real  value,  especially  in  so  far  as  it  is 
based  on  direct  character-analysis.  But  when  he  (and  his  co-workers)  make  the 
sweeping  statements  they  do — though  without  arguing  them  out  critically — about 
the  standing  of  physical  law  in  the  determination  of  mental  phenomena,  they  as- 
sume the  authority  of  philosophers  and  make  themselves  correspondingly  responsi- 
ble. 


James  J.  Putnam 


I5I 

equally  fruitful  with  that  which  it  has  had  and  yet  one 
markedly  different  in  origin  and  detail.  This  portion  of 
medical  progress  needed  to  be  guided  by  just  such  a man 
as  Sigmund  Freud,  and  we  may  be  deeply  grateful  for  his 
advent.  He  taught  us  to  abstain  from  referring  psycho- 
pathic “symptoms”  (exclusively  or  primarily)  either  to 
bodily  malnutrition  or  hereditary  taint  (often  such  lame  and 
insufficient  modes  of  explanation),  still  less  to  lack  of  will 
on  the  patient’s  part;  and  threw  the  primary  emphasis, 
instead,  on  a set  of  definite  psychologic  causes  which  he 
showed  how  to  bring  out,  in  detail,  with  reference  to  each 
special  case.  But  in  his  eager  search  for  causes,  he  took  as 
his  standard  the  rigid  kinds  of  causation  studied  by  the  physi- 
cist, and  so  became  committed  to  a mode  of  conceiving  the 
manifestations  of  human  effort  which  does  not  do  them 
justice.  This  was  a misapplication  of  the  scientific  method, 
but  the  effort  of  which  it  formed  a part  was  practically 
fruitful  and  stimulating  to  research. 

The  different  phases  of  Freud’s  thought  followed  each 
other,  to  some  extent,  in  chronological  series.  I prefer,  how- 
ever, to  disregard  this  circumstance,  which  has  no  signifi- 
cance for  the  purpose  of  this  study,  and  ask  your  attention 
rather  to  the  fact  that  they  are  present  and  closely  inter- 
woven throughout  all  his  work.  That  is,  the  same  consti- 
tutional tendencies  of  mind,  the  same  sort  of  personal 
equation,  have  been  operative  continuously,  from  the  out- 
set, and  have  acted,  I believe,  very  favorably  as  regards  one 
portion  of  his  work,  less  so,  and  even  unfavorably,  as  re- 
gards other  portions. 

Assuming,  for  example  (what  is  substantially  correct), 
that  these  various  attitudes  or  tendencies  of  mind,  by  virtue 
of  the  fact  that  they  belonged  to  Freud’s  personality,  came, 
all,  rapidly  into  play,  and  taking  into  account,  as  one  should, 
his  rugged  courage  and  thorough-going  honesty,  and  the 
fact  that  he  had  been  trained  in  the  scientific  rather  than  in 
the  philosophic  school,  one  may  perceive  that  something 
of  the  following  sort  must  have  taken  place:  He  began  his 
work  with  a therapeutic  aim, — that  is,  with  the  interests 
of  given  patients  in  his  mind.  If  he  had  been  content  to 
remain  a therapeutist,  without  publishing  much  beyond  an 


152 


The  Work  of  Sigmund  Freud 


enumeration  of  the  cures  that  he  had  made;  or  if  he  had 
confined  his  published  statements  to  a few  clinical  generaliza- 
tions, and  a few  broad  hints  about  the  importance  of  the  sex 
issues,  such  as  Charcot  had  thrown  out,  he  would  un- 
doubtedly have  achieved  reputation  and  success.  But  his 
genius  (untempered  and  unhampered,  in  the  main,  by  con- 
siderations of  practical  policy  and  personal  aggrandizement) 
would  not  permit  this  cramping.  Obviously,  he  soon  per- 
ceived that  the  needs  of  his  patients — if  they  were  to  gain 
anything  through  the  truth  as  he  saw  it— would  require  them 
to  look  on  their  lives  with  the  same  inexorable  seriousness 
that  would  be  required  for  the  successful  carrying  through 
of  a difficult  scientific  research.  And  more  than  this,  he 
soon  gained  a vision  of  the  needs  of  society  as  reflected  and 
expressed  in  those  of  the  single  patient;  and  a vision,  too,  of 
the  vastness  of  the  part  played,  in  the  lives  of  historical 
characters  and  of  the  imaginers  of  those  described  in  fiction 
and  in  myth,  by  the  hidden  motives  of  which  he  had  found 
himself  on  the  trail.  Finally,  stimulated  by  his  success  in 
using  the  genetic  method  (that  is,  in  tracing  out  the  working 
of  the  apparently  blind,  will-less,  primary  instincts  in  even 
the  highest,  that  is,  the  most  complex,  manifestations  of 
conscious  human  life),  Freud  was  led  to  adopt  the  general 
views  which  must  be  classified  as  “determinstic”  in  a 
philosophic  sense.  But  he  gives  no  adequate  arguments 
to  support  these  views,  and  it  is  here,  in  my  opinion,  rather 
than  in  his  (monographic)  over-emphasis  of  the  sex-motive, 
that  the  scientific  weakness  of  his  work  is  to  be  found.  It 
has  been  urged  against  him,10  that  in  his  sociological  studies — 
which  have  been  incidental  rather  than  serious  or  exhaustive 
— he  has  not  given  sufficient  attention  to  the  various  in- 
fluences, other  than  those  based  on  sex,  by  which  men  living 
in  social  groups  are  practically  moved, — preeminently  the 
gregarious  instinct  in  its  different  forms.  Freud  has  met 
this  criticism  indirectly  in  one  of  his  recent  papers,  where 
he  admits  that  he  has  not  as  yet  studied  with  care  what  he 
calls  the  “ego”  complexes.  He  seems  to  refer  this  failure  to 
lack  of  time  and  opportunity;  but  he  says,  also,  that  he  has 

10Trotter:  Instincts  of  the  Herd  in  Peace  and  War.  Dr.  G.  Stanley  Hall 
and  others  have  given  voice  to  similar  criticisms. 


James  J.  Putnam 


153 


as  yet  seen  no  unifying  principle  that  promises  more  for  the 
purposes  of  such  a study  than  the  sex-principle.  I would 
offer,  as  a partial  explanation  of  this  situation,  the  fact 
referred  to  at  the  beginning  of  this  paper,  that  his  chief 
instinctive  interest  and  the  best  opportunity  for  his  method 
have  lain  elsewhere  than  in  the  fields  of  sociologic  research, 
in  a broad  sense.  In  spite  of  this,  he  has  been  obliged  to 
figure,  more  or  less,  as  a sociologist,  and  cannot  long  escape 
from  assuming,  explicitly,  the  responsibility  attaching  to  the 
authority  thus  thrust  upon  him. 

The  recognition  of  the  wider  needs  and  scientific  issues 
which  his  empirical  study  of  men’s  unconscious  motives 
brought  to  fight,  together  with  the  increasing  realization  of 
the  therapeutic  difficulties  involved  in  many  of  his  cases, 
doubtless  augmented  Freud’s  determination  to  search  out 
to  the  utmost  every  indication  of  repressed  “sexuality,” 
and  this  brought  him  much  criticism,  which  was  only  rel- 
atively sound. 

The  time  is  not  ripe,  even  yet,  for  laying  d-own  rules 
that  would  enable  the  physician  to  decide  how  far  he  should 
encourage  a given  patient  to  go  in  this  spying  out  of  the 
repressed  sensual  elements  in  his  thoughts  and  conduct. 

Freud  started  from  the  thesis11  that  the  conscientious 
psychoanalyst  ought  to  be  considered  as  within  his  rights 
and  duty  in  dealing  with  these  issues — or  encouraging  his 
patients  to  deal  with  them — just  as’  with  any  other  issues. 
He  held  it  to  be  best  to  encourage  plain  speaking,  as  in  line 
with  the  assumption  that  both  he  and  his  patients  were  to 
be  regarded  as  engaged,  single-mindedly,  in  carrying  out  a 
serious  research,  and  as  aiming  for  an  education  which,  so 
far  as  it  went,  should  be  genuine  at  least.  Conscious  of  the 
rectitude  of  his  own  motives,  Freud  felt  convinced  that  the 
evils  attendant  on  this  plan  of  outspokenness  were  far  less 
serious  than  those  attendant  on  the  plan  of  covered  speech 
and  careful  phrasing  that  would  permit  of  much  juggling 
with  subtle  tendencies  to  sensuality.  Doubtless  there  are 
dangers  in  all  methods,  and  perhaps  time  will  show  that  the 
essential  point  is  that  the  physician  should  know  himself 

11  Sharply  defined  and  illustrated,  for  example,  in  his  “Bruchstuck  einer 
Hysterie- Analyse,  ” Monatschr.  f.  Psychiatrie  u.  Neurologie,  Bd.  XXVIII,  H.  4. 


i54 


The  Work  of  Sigmund  Freud 


with  a thoroughness  that  should  be  as  nearly  absolute  as 
possible,  and  then  vary  his  method  more  or  less  with  re- 
ference to  the  given  patient’s  symptoms,  habits  of  mind  and 
previous  training.  That  he  should  do  this  is,  indeed,  im- 
plied by  Freud  in  his  urgent  insistence  on  letting  the  patient 
virtually  lead  in  the  research  while  the  physician  and  his 
views  are  held  as  in  abeyance.  But  this  is  a recommendation 
difficult  to  follow  in  some  cases.  Patients,  by  virtue  of  their 
instinctive  power  of  insight,  are  close  students  of  the  physi- 
cian’s personality,  and  whatever  he  may  say  or  leave  unsaid, 
his  standards  will  always  be  taken,  more  or  less,  as  guides. 
This,  too,  the  patient,  by  the  theory,  must  learn  to  see  and 
voice,  but  even  such  an  antidote  to  harm  will  sometimes  fail. 

The  therapeutic  situation  was  unsatisfactory  in  several 
respects  at  the  period  when  Freud  began  his  investigations, 
and  indeed  it  is  so  still.  The  relationship  between  physicians 
and  their  neuropathic  patients,  in  particular,  was  marked  by 
subtle  evils  of  a somewhat  serious  sort.  In  proportion  as 
neurological  practitioners  were  successful,  their  own  per- 
sonalities played  too  pronounced  a part:  they  were  prone  to 
become  either  too  masterful  or  too  intimate,  in  response  to 
a willingness  and  even  a longing,  on  their  patients’  part,  to 
play  a complementary  role  in  these  respects. 

This  was  an  abuse,  which,  in  accordance  with  Freud’s 
definition  of  the  term,  could  fairly  be  called  “sexual”  in  its 
nature;  and  the  fashion  for  hypnotism,  so  prevalent  at  one 
time,  only  increased  the  danger  while  making  it  more  difficult 
of  detection.  One  of  the  benefits  to  be  expected  as  an  out- 
come of  the  psychoanalytic  movement  is  that  relationships 
of  a more  straightforward  sort  between  doctors  and  patients, 
will,  hereafter,  be  encouraged,  and  equivocal,  debilitating 
relationships  discouraged.  Freud  and  his  followers12  have 
striven  hard  for  a better  state  of  things  in  this  respect,  but 
it  must  be  clearly  seen  that  the  condition  essential  for  a 
permanent  improvement  is  the  adoption  of  high  standards 
among  physicians  themselves.  Self-knowledge  can  be  a 
stepping-stone  to  this,  but  it  must  lead  to  an  instinctive 
attitude,  transcending  knowledge;  and  it  is  as  difficult  for 

12 See  “Presidential  Address”  by  Dr.  W.  A.  White,  in  forthcoming  issue  of  the 
Psychoanalytic  Review. 


James  J.  Putnam 


155 


the  physician  to  gain  this  for  himself  as  it  is  for  the  patient 
to  overcome  his  more  obvious  symptoms.  It  is  extremely 
difficult  to  bring  about  a genuine  and  permanent  elevation 
of  the  character-level  in  any  person,  sick  or  well,  and  some- 
times one  has  to  rest  content  with  a gain  which  is  but  super- 
ficial. But  even  this  is  of  some  value,  as  Freud  himself  has 
pointed  out13  in  his  comments  on  the  breaking  down  of 
pseudo-civilization  under  the  stress  of  war. 

Considerations  of  the  above  sort  should  help,  to  explain, 
if  not  altogether  to  justify,  some  of  Freud’s  interpretations 
in  another  field. 

It  is  true  that  one  does  not  find,  in  the  character-studies 
by  him  and  by  his  closest  followers,  of  such  men — actual  or 
fictitious — as  Leonardo,  Hamlet  and  the  like,  or  of  the 
myth-makers  and  the  primitive-culture  men,  signs  of  a well- 
balanced,  judicial  weighing  of  the  all-various  forces  actually 
in  play.  This  is  not  even  attempted,  indeed;  and  instead,  we 
are  given  an  interesting  and  keen  analysis  of  certain  con- 
cealed influences  which,  in  their  turn,  the  antecedent  biog- 
raphers had  neglected.  This  situation  is  typical  of  the 
whole  psychoanalytic  movement,  in  its  strength  and  in  its 
weakness,  or  defect.  These  character-analyses  are  not 
biographies  but  monographic  studies  of  certain  tendencies 
which  ought  to  be  better  understood.  One  should  not  rail 
against  the  defects  of  this  tendency,  however,  without 
remembering  that  except  for  this  exaggerated  emphasis  the 
vitally  important  motives  now  brought  out  would  never 
have  been  seen.  A community  ignorant  of  itself,  and 
ignorant  of  its  ignorance,  yet  stung  by  the  suspicion  of  its 
own  narrowness,  and  of  weaknesses  and  temptations  which 
it  does  not  realize  the  importance  of  facing  in  all  their 
bearings,  is  naturally  hostile  to  a frankly  truthful  interpreter 
of  the  facts  as  they  seem  to  him,  and  one  prepared  to  state 
them  baldly  in  accordance  with  the  principle  de  potiori 
denominatio  fit. 

It  was  inevitable  that,  in  proportion  as  his  observations 
accumulated,  Freud  should  generalize  them,  in  the  form  of 
propositions  which  came  to  serve  at  once  as  expressions 
of  his  past  experience  and  formulations  for  his  and  others’ 

13Cf.  “Zeitgemasses  iiber  Krieg  und  Tod;  die  Enttauschung  des  Krieges.” 


1 56 


The  Work  of  Sigmund  Freud 


use  in  further  studies.  To  many  persons,  amongst  whom  I 
would  include  myself,  these  formulations  seem  in  the  main 
sound  and  useful.  Their  validity  has,  however,  been  strong- 
ly called  in  question,  and  certain  of  the  objections— those  by 
Adler  and  by  Jung— must  be  very  briefly  commented  on. 
I refer  especially  to  the  propositions  about  infantile  sexuality, 
fixation  and  regression. 

It  is  of  great  interest  to  decide  whether,  on  strictly 
scientific  grounds,  there  is  any  good  justification  for  the 
claim  made  by  Alfred  Adler14  that  Freud  is  entirely  at  sea  in 
using  the  category  of  sexuality  as  primary  and  basal.  It  is 
only,  Adler  claims,  the  will  for  power,  or  self-assertion  (or, 
eventually,  self-preservation)  that  should  be  looked  upon  as 
a basal  motive,  the  sexual  impulse  being  classifiable  as 
secondary,  or,  in  Adler’s  own  words,  only  as  a form  of  speech , 
in  which  another  and  deeper  influence  reveals  itself. 

This  view  is  interesting,  but  as  a criticism  of  Freud’s 
position  it  can  not,  I think,  maintain  its  ground. 

In  the  first  place,  Freud  was  making,10  not  a biologic, 
but  a clinical  argument  when  he  asserted  the  fundamentality 
of  the  sex-motive.  It  was  a question  solely  of  fundamental- 
ity in  the  patient’s  mind;  and  surely  patients  are  not  torn  and 
thrilled  by  their  desire  for  supremacy  (regarded  as  freed — 
if  one  can  so  regard  it — from  the  sex-feelings  that  attend  it) 
at  all  as  they  are  torn  and  thrilled  by  their  (unrecognized  and 
unacknowledged)  sex-passions.  Neither  is  the  repression 
discoverable  in  the  one  case  at  all  comparable  to  that  met 
with  in  the  other.  And  as  patients  cannot  be  expected  to 
abandon  the  sex-conceptions  and  terminology  in  describing 
their  ideas  and  feelings,  it  would  be  a forced  and  artificial 
demand  to  make  of  the  clinical  observer  that  he  should  do  so. 

But,  to  go  further,  it  cannot,  in  my  estimation,  be 
claimed,  on  any  ground,  that  the  category  of  “self  assertion 
is  more  fundamental  than  that  of  “sexuality.’'  Neither, 
on  the  other  hand,  is  anything  to  be  gained  by  asserting  (true 
though  it  is,  as  a rule,  from  the  patient’s  standpoint)  that 

1?Cf.  “Ueber  den  nervosen  Cbarakter.”  (Now  to  be  had  in  English.)  Every 
one  who  cares  about  the  truth  of  these  matters  should  read  Adler’s  own  words 
and  note  their  animus,  which  is  one  of  very  unscientific  virulence. 

15See  his  admirable  statements  in"‘Zur  Geschichte  der  psychoanalytischen 
Bewegung.” 


James  J.  Putnam 


157 


the  reverse  shoufd  be  maintained.  In  fact,  both  of  these 
exceedingly  important  categories  or  modes  of  classification 
imply  that  a man  is  to  be  thought  of,  first  of  all,  as  a social 
animal,  a virtual  member  of  a virtual  community. 

But,  in  theory  and  in  an  ideal  sense,  the  members  of  a 
community  meet,  not  as  rivals  but  as  equals  and  in  coopera- 
tion; and  where  rivalry  or  misunderstanding  arises  among  the 
members  of  human  societies,  men,  sooner  or  later,  come  to 
recognize  the  need  for  an  intermediator,  or  “interpreter” 
in  Royce’s  sense.16  Indeed,  it  is  possible  that  this  function 
is  foreshadowed  even  in  the  animal  kingdom — as,  pre- 
eminently, by  the  appearance  of  the  offspring,  who  requires 
the  joint  care  of  the  father  and  mother,  and  serves  as  a 
pledge  of  fellowship  and  cooperation.  It  is  true,  of  course 
(and  this  has  long  been  recognized  by  Freud),  that  the  lust 
for  power,  whether  for  its  own  sake  or  (as  urged  by  Adler)  in  a 
compensatory  sense,  is  relatively  primitive  and  fundamental 
enough,  in  all  conscience.  But  no  good  reasons  exist,  I 
think,  for  looking  on  it  otherwise  than  as  secondary  to  the 
cooperative,  gregarious  or  “herd”  instinct,  or  as  more 
fundamental  than  the  sex-instinct.  To  live— even  to  think 
— is  to  strive  to  reproduce  oneself:  that  amount  and  form  of 
creation  at  least  is  necessary  and  universal.  But  the  con- 
ditions essential  for  the  ideal  community  do  not  imply,  as 
theoretically  necessary,  a s ex-problem  (in  a “morbid”  sense); 
nor  does  the  bare  existence  of  a community  theoretically 
require  a supremacy-problem.1' 

It  will,  I trust,  be  believed  that  I have  no  desire  to  be- 
little the  value  of  Alfred  Adler’s  contributions  to  the  working 
out  of  the  principles  of  compensation  (as  for  organ-in 
feriority),  or  to  deny  the  significance  of  the  principle  of  self 
assertion  and  the  “fictitious  goal”  of  the  neurotic  patients 
- — amongst  whom  all  men  are  to  be  reckoned.  Freud  has 
always  recognized  these  principles. 

16Cf.  Royce:  War  and  Insurance;  The  Hope  of  the  Great  Community,  and 
other  publications. 

17I  will  call  attention,  in  passing,  to  the  fact  that  just  as  men  slip  or  drift 
easily  into  rivals,  in  Adler’s  sense  (j.  <?.,  into  a relationship  which  is  a sort  of 
mockery  of  co-operation),  so  Royce’s  community  of  interpretation  (a  triadic  re- 
lationship of  good  sort)  is  mocked  in  the  form  described  by  Freud  in  which  a man 
and  a woman  are  unable  to  love  each  other  to  the  full  extent  except  in  the  virtual 
presence  of  a rival. 


i5» 


The  Work  of  Sigmund  Freud 


It  is  also  true  that  philosophy  began,  practically,  with 
the  demands  for  solution  of  the  problem  of  evil,  and  that  the 
sex-problem  and  the  supremacy  problem,  arising  side  by 
side,  had  much  to  do  with  the  modern  doctrines  of  sociology 
and  characterology.  But  it  was  a serious  wrong,  on  Adler’s 
part,  to  attempt  to  destroy  where  his  obvious  function  was 
to  emphasize  and  to  consolidate. 

As  regards  the  criticisms  brought  by  Jung  against 
Freud’s  formulations,  I see  in  them  the  suggestion  of  a mode 
of  looking  at  the  subject  which  the  former  found  congenial 
while  to  the  latter  it  was  not  so,  combined  with  what  seems 
to  me  a needless  denial  of  some  of  Freud’s  most  important 
claims. 

Jung  strives  for  a broader  formulation  of  the  whole 
situation  than  Freud,  with  his  primarily  clinical,  or  em- 
pirical, interests,  had  adopted;  and  somewhat  as  Freud  sees 
the  infant  behind  the  adult,  so  Jung  sees  nature,  striving  to 
organize  itself,  behind  man.  The  “mother,”  conceived  of 
concretely,  disappears,  therefore,  in  the  creative  instinct, 
and  in  the  instincts  of  dependence,  from  which  man  must  free 
himself.  These  are  justifiable  and  interesting  views,  and  the 
data  used  in  illustration  of  them  are  very  rich. 

It  is  easy  for  me  to  understand  and  sympathize  with 
Jung’s  desire  for  this  broader  formulation,  and  easy,  too,  to 
understand  his  wish  to  be  of  more  service  to  the  patient  with 
reference  to  the  “present  issue.”  On  the  other  hand,  I can 
sympathize  very  strongly,  also,  with  the  feeling  of  Freud  and 
his  friends,  that  to  go  far  in  this  latter  course  would  often  be 
to  impose  one’s  own  personality  upon  the  patient,  and  would 
lead  inexperienced  students  of  psychoanalysis  to  abandon 
methods  in  the  use  of  which  more  rigid  studies  might  have 
made  them  competent.  Furthermore,  I cannot  in  the 
least  sympathize  with  the  rejection  by  Jung  of  Freud’s 
theories  of  regression,  infantile  sexuality,  and  fixation. 
Jung  carries  out  his  analyses,  so  he  says,  in  the  old  fashion, 
and  it  is  difficult  to  see  how  he  can  fail  to  recognize  the  value 
of  the  principles  which  he  formerly  used  so  extensively  and 
with  such  good  effect.  The  theory  of  fixation  can,  indeed,  be 
stated  in  such  technical  fashion  that  it  seems  repellent  to  the 
novice;  but  it  can  also  be  stated  in  terms  that  make  it  accept- 


James  J.  Putnam 


159 


able  to  every  person  of  intelligence,  even  if  untrained. 

As  regards  the  philosophic  problem,  I have  but  one  word 
more  to  add.  Freud  has  pointed  out,  with  eminent  justice, 
that  the  mind  of  the  philosopher,  if  subjected  to  analytic 
study,  reveals  itself  as  under  two  influences,  one  of  which  is 
a craving,  of  infantile  origin.  The  scientific  mind  is  free, 
he  thinks,  from  this  doubleness  of  motive.  This  is  true, 
if  the  proposition  be  taken  in  Freud’s  sense.  But  to  my 
thinking,  the  scientific  mind  is  from  another  standpoint 
eminently  narrow,  and  subject  to  modes  of  reasoning  that 
do  not  satisfy  all  the  requirements  of  the  situation. 

If  a “ unit  of  composition ” must  be  adopted,  in  order  to 
satisfy  the  need  for  a monistic  scheme,  which  we  all  feel,  this 
cannot  be  such  a unit  as  would  be  available  solely  for  the 
arbitrarily  chosen  portion  of  existence  which  alone  can  be 
studied  by  scientific  methods.  We  are  men,  with  all  that 
that  implies,  before  we  decide  to  limit  our  researches  or  to 
begin  them,  and  should  not  let  ourselves  be  contented  with 
modes  of  defining  what  we  are  that  cannot,  if  carried  out 
logically,  be  considered  as  otherwise  than  cramping. 

The  feeling  would  not  have  been  so  intense,  on  the  part 
of  Freud  and  his  adherents,  with  regard  to  the  change  of 
front  by  Dr.  Jung  toward  some  of  the  most  fundamental  of 
the  psychoanalytic  doctrines — especially  the  doctrine  of 
infantile  sexuality  and  its  bearings,  and  that  which  affirms 
the  therapeutic  significance  of  tracing  out,  through  careful 
analysis,  the  complete  history  of  the  patient’s  fixations  and 
regressions — unless  these  men  had  felt  that  the  success  of  a 
very  difficult  enterprise  was  at  stake.  It  is  proper  that  the 
grounds  of  this  feeling  should  be  understood,  not  only  be- 
cause the  doctrines  in  question  are  so  important  that  one 
cannot  give  them  up  and  yet  fairly  call  oneself  a psycho- 
analyst, in  Freud’s  sense,  but  also  because  the  pressure  to 
give  them  up,  or  modify  them,  is  still  so  strong  and  subtle. 

The  fact  is,  there  are  a great  many  persons  who  would 
gladly  avail  themselves  of  Freud’s  doctrines  to  the  extent  of 
making  a partial,  relatively  superficial  analysis  of  thoughts 
and  memories,  yet  who  would  strongly  shrink — the  physi- 
cians from  urging,  the  patients  from  being  urged — to  make 


160  The  Work  of  Sigmund  Freud 

this  process  thoroughgoing.  Certain  though  it  is  that  many 
changes  will  creep  gradually  into  psychoanalytic  procedures, 
it  is  exceedingly  desirable  that  these  should  be  made  by  physi- 
cians who  have  not  only  been  thoroughly  trained  in  what 
might  be  called  orthodox  method  and  beliefs,  but  who  still 
accept  as  sound  the  principles  upon  which  these  are  based. 
Otherwise,  the  method  will  degenerate,  and,  more  and 
more,  the  old  reliance  on  the  mentor-  and  adviser-types 
of  psychotherapeutist  will  gradually  be  reverted  to,  not 
alone  with  reference  to  the  class  of  cases  where  their  services 
suffice,  but  for  all  cases. 

Fortunately,  however,  this  result  is  not  likely  to  happen 
to  the  degree  that  one  might  fear.  The  teachings  of  Freud 
and  his  colleagues  as  to  the  benefits  to  be  gained  through  a 
thorough  searching-out  of  his  unacknowledged  experiences, 
on  the  patient’s  part,  have  become  so  far  ingrained  in  psycho- 
therapeutics that  the  lesson  is  never  likely  to  be  entirely 
unlearned.  What  is  more  to  be  feared  is  that  therapeutic 
traditions  may  arise  that,  while  considered  of  the  best,  will 
be,  in  fact,  less  good  than  they  might  otherwise  have  been, 
and  that  the  scientific  outcome  of  the  psychoanalytic  move- 
ment may  suffer  correspondingly. 


II.  Notes  with  Reference  to  Freud,  Jung  and  AiJler 

BY  TRIGANT  BURROW,  M.  D.,  PH.  D. 

AMONG  the  psychoanalysts  who  have  dissented  from 
the  teachings  of  Freud,  the  most  prominent  and 
significant  figure  is  Jung,  and  next  in  importance, 
Adler.  More  than  any  others  these  two  writers 
have  contributed  to  check  the  necessarily  difficult  progress 
of  the  Freudian  tide.  But  for  all  the  criticism  and  defection 
which  these  deprecating  voices  have  aroused  in  the  pro- 
fessional and  lay  mind,  I hold  that  their  positions  are  not 
essentially  irreconcilable  with  Freud. 

That  which  is  subsumed  under  the  term  “Freud”  is  a 
scientific  observation  relative  to  the  genus  man.  It  denotes 
the  tabulation  of  a phenomenon.  It  marks  a discovery. 
I am  speaking  now  of  Freud  entirely  from  the  point  of  view 
of  the  dogma  of  science.  The  question  as  to  whether  Freud 
is  humanly  acceptable  with  respect  to  his  observations  is  not 
in  order.  This  is  not  the  concern  of  the  scientific  observer. 
It  is  the  man  who  is  advocating  a cause,  expounding  a theory, 
or  exploiting  a doctrine,  who  has  to  be  “right”  in  this  sense. 
But  Freud  is  merely  observing  a fact,  and  the  man  who 
observes  a fact  is  preserved  in  his  integrity  by  virtue  of  his 
fact. 

In  a discussion  of  the  relative  views  of  Freud  and  Jur.g 
we  are  apt  to  overlook  an  important  point  which  will  largely 
assist  in  clarifying  matters  with  respect  to  the  difference 
between  Freud  and  those  who  diverge  from  him.  It  is  one 
thing  to  disagree  with  Freud,  the  observer,  and  in  so  doing 
to  deny  the  criteria  of  science,  and  quite  another  to  offer 
palliations  intended  to  mitigate  the  poignancy  of  unwelcome 
consequences  inseparable  from  the  observations  of  Freud. 
It  is  my  feeling  that  this  has  been  the  essential  aim  of  Jung’s 
teaching  and  if  in  his  impatience  he  has  been  lead  into  funda- 
mental disagreement  with  Freud,  his  inadvertence  has  been 


161 


162  Notes  with  Reference  to  Freud , Jung  and  Adler 

due  to  his  eagerness  to  propitiate  unacceptable  alternatives. 2 

I maintain,  then,  that  Jung’s  digression  from  Freud  is 
of  the  nature  of  a difference,  rather  than  a disagreement, 
and  if  this  is  true,  it  puts  Jung’s  position  in  a changed  light. 
I think  this  distinction  cannot  be  overemphasized.  I know 
that  for  myself  I agree  with  Freud  unequivocally,  but  I also 
know  that  in  certain  respects  I unhesitatingly  differ  from 
him.  I differ  from  Freud,  for  example,  when  he  says  that 
sexual  repression  is  due  to  the  interdictions  of  society,  but 
I differ  from  him  not  because  of  disagreement.  On  the 
contrary,  it  is  rather  through  the  fuller  agreement — it  is 
rather  that  in  this  position  Freud  does  not  seem  to  me 
Freudian  enough,  so  to  speak.  One  must  discriminate, 
then,  between  a divergence  from  Freud  that  is  due  to  a 
difference  in  point  of  view  and  one  that  is  due  to  a disagree- 
ment. 

From  this  standpoint  it  seems  to  me  that  Jung  and 
Adler  are  in  the  main  quite  right  in  their  general  principles, 
and  that  their  error  consists  in  the  dissent  from  Freud  which 
they  have  assumed  to  be  inevitable  in  the  modifications  of 
his  principles  as  embodied  in  their  respective  teachings. 
Had  Adler,  for  example,  stated  simply  that  an  inherent 
egotism  underlies  the  manifestations  of  neurotic  states,  had 
he  pointed  out  that  in  certain  types  of  reaction,  as  in  stam- 
merers, there  is  present  an  exaggerated  self-assertion — a 
disproportionate  overvaluation  of  the  self,  and  had  he 
recognized  that  this  reaction  in  these  patients  is  just  another 
expression  of  the  manifold  forms  of  vicarious  sexual  mani- 
festation, I think  no  psychoanalyst  who  is  familiar  with 
these  cases  would  have  taken  issue  with  him. 

Substitutive  reactions  of  an  analogous  character — those 
in  which  the  ego  is  overemphasized  as  a result  of  repression 
of  the  libido — bad  been  long  ago  recognized  by  Freud.  Such 
has  been  precisely  the  mechanism  to  which  he  long  ago  drew 
attention  in  his  interpretation  of  paranoia,  with  its  self- 

2 After  all,  observation  is  not  the  only  duty  of  science.  Presentation  is  no  less 
important.  To  communicate  one’s  findings  aptly  and  appropriately  and  thus 
gain  the  sympathy  and  acceptance  of  one’s  audience  is  a task  that  seems  to  me  to 
rank  equally  with  that  of  faithful  observation  itself.  Apt  presentation  invites  a 
sympathetic  understanding  through  assimilating  the  new  with  the  customary  aims 
and  methods  out  of  which  the  new  has  taken  its  growth, 


Trigant  Burrow 


163 


references,  its  ideas  of  persecution,  its  delusions  of  grandeur 
and  its  hypertrophy  of  the  ego  generally.  The  mechanism 
underlying  the  psychology  of  stammering  is  really  identical 
Avith  that  of  paranoia.  In  both,  there  is  the  desperate  re- 
course to  egoistic  overvaluation  in  the  effort  to  evade  a 
poAverfully  determined  subjectivity  of  the  sexual  libido,  or 
so-called  unconscious  homosexuality.  The  stammerer  re- 
presents in  reality  a somatic  paranoia.  Instead  of  the  con- 
struction of  the  mental  system  seen  in  the  elaborations  of 
paranoia,  the  ego-complex  of  the  stammerer  shoAvs  itself 
in  an  overcharge  of  the  affective  life,  that  manifests  itself 
✓ in  connection  with  the  social  adjustments  as  specifically 
mediated  through  speech. 

The  situation  is  similar  with  Jung  in  his  hypothesis  of  a 
presexual  mode.  As  I understand  it,  his  sense  of  the  term 
presexual  implies  the  existence  of  a mode  that  is  not  only 
presexual  in  that  it  precedes  the  pleasure  mode,  but  that  is 
presexual  in  the  sense  of  a generic  contrast — a contrast 
which  assumes  a non-continuity  with  the  sexual  mode. 
Here,  it  seems  to  me,  is  an  instance  in  Avhich  Jung  is  entirely 
defensible  in  his  view,  but  unwarranted  in  the  manner  of  it 
and  in  the  subsequent  implications  it  entails. 

In  positing  a presexual  mode  of  consciousness,  I am 
heartily  in  accord  with  Jung.  The  whole  significance  of  the 
sexual  phase  of  consciousness  and  of  the  unconscious  is  in- 
conceivable to  me  in  the  absence  of  the  conception  of  this 
presexual  phase.  To  state  it  figuratively,  the  whole  notion 
of  the  sin  of  sex  as  symbolized  in  the  expulsion  of  the  first 
man  from  the  Garden  of  Eden  is  to  me  unthinkable  in  the 
absence  of  a Garden  of  Eden.  I call  this  phase  the  precon- 
scious,  but  in  this  term  as  I use  it  there  is  implied,  as  the 
name  indicates,  no  such  distinction  as  Jung’s  “vital  energy,” 
but  a distinction  that  is  based  solely  on  a developmental 
difference,  my  conception  of  a presexual  mode  being  not  only 
not  incompatible  with  Freud,  but,  as  it  seems  to  me,  a re- 
quisite correlate  of  his  teaching. 

The  unconscious  of  Freud  is  the  sphere  of  repression, 
or  of  sex-inhibition.  If  one  prefers,  he  may  denote  the 
Freudian  conception  of  sex  as  the  sphere  of  the  pleasure 
aims,  as  Freud  himself  does  when  he  speaks  of  the  “pleasure- 


164  Notes  with  Reference  to  Freud , Jung  and  Adler 

principle;”  or  he  might  sum  up  the  unconscious  as  the  desire 
life , in  its  broadest,  most  basic  sense.  For  that  which  is 
inherent  in  sex  is  the  covetous  aim.  It  carries  essentially 
the  notion  of  attaining  satisfaction,  of  possessing  for  one’s 
self.  Thus,  desire  is  the  essential  element  in  the  aims  of 
sex.  Of  course  desire  presupposes  an  element  of  assessment. 
Desire  is  to  look  upon  an  object  and  pronounce  it  good  to 
have.  Such  is  the  meaning  of  “desirable.”  And  so,  in  this 
reaction  of  desire  there  is  involved  a judgment.  It  is  a 
process  of  cognition,  and,  however  complete  or  incomplete, 
however  frank  or  repressed,  an  act  of  cognition  is  an  act  of 
consciousness.  n 

Now  there  is  a period  covering  many  months  before 
cognition  may  be  predicated  of  the  infant,  in  which  the 
organism  is  the  subject  of  a condition  of  comfort  or  repletion. 
That  is,  before  it  may  be  said  to  experience  satisfaction  in 
any  conscious  sense,  the  organism  does  at  least  embody 
satisfaction  as  a condition  of  being.  It  is  this  state  of  tran- 
quil quiescence,  representative  of  the  infant’s  existence 
prior  to  the  inception  of  cognition,  that  I call  the  precon- 
scious.  It  is  thus  a pre-judicial,  a pre-conative,  a pre- 
covetous  phase  of  consciousness — a phase  of  consciousness 
which  precedes  the  desire  or  the  sexual  phase. 

For  if  the  primary,  conative  phase  of  consciousness 
(what  is  known  in  adult  life  as  the  repressed  unconscious) 
is  sexual,  then  the  preconscious — the  phase  which  precedes 
this  sexual  or  desire  phase  and  out  of  which  the  sexual 
evolves  with  the  onset  of  cognition — is  surely  also  presexual. 

If  I have  made  my  position  clear,  this  conception  of  a genetic 
presexual  mode  to  which  the  trend  of  my  investigations  leads 
me,  entails  no  dissent  whatsoever  from  Freud  and  the  un- 
conscious as  envisaged  by  him. 

Now  the  point  is  that  the  presexual  mode  as  conceived 
by  Jung  does,  on  the  contrary,  assume  features  which  de- 
mand an  entirely  altered  conception  of  the  unconscious  and 
of  the  fundamental  teachings  of  Freud.  I might  go  on  citing 
other  instances  of  Jung’s  divergence  from  Freud  and  in 
general  point  out  in  them,  as  in  the  instance  just  mentioned, 
the  unessential  disparity  of  his  hypotheses.  More  than  that, 
it  could  be  shown,  I think,  that  Jung’s  conceptions  could 


Trigant  Burrow 


165 

well  have  assumed  a quite  complemental  position  with 
respect  to  Freud,  and  with  entire  consistency  as  regards 
their  fundamental  import. 

I think,  for  example,  that  Jung  is  correct  in  saying  that 
there  is  contained  in  dreams,  as  in  life,  a non-sexual  clause. 
I think  there  is  in  life  a factor  that  is  preclusive  of  sex.  I 
do  not  mean  the  repressive  factor,  exhibited  in  the  censor- 
ship of  social  inhibition.  This  is  a quite  secondary,  artificial 
proscription,  reacting  in  response  to  an  external  agency. 
But  I mean  a primary  and  inherent  non-sexual  tendency, 
the  biology  of  which  is  traceable  to  the  embryonic  matrix 
of  consciousness  represented  by  the  preconscious  mode. 

In  my  view  it  is  only  after  clearing  away  the  inter- 
polations of  sex  as  represented  in  the  antisocial  demands 
belonging  to  the  furtive  unconscious  mode,  that  the  native 
presexual  mode  becomes  assimilable  with  adult  social  aims. 
But  when  Jung  advances  the  hypothesis  of  unconscious 
trends  aiming  directly  toward  constructive  social  goals,  it 
seems  to  me  we  are  carried  along  by  an  over-hasty  optimism 
that  leaves  us  quite  breathless  and  dismayed.  Here,  too, 
Jung’s  assumptions  are  made  at  the  cost  of  Freud’s  objective 
observations.  Again  it  is  Jung’s  manner  of  approach  that 
seems  to  me  mistaken. 

My  position  is  that  it  is  sheer  blindness  not  to  recognize 
that  Freud  has  held  faithfully  to  deliberate  observation  in 
reporting  the  exclusive  assertion  of  sex  as  disclosed  in  the 
symbolic  disguises  of  the  unconscious.  Yet  I feel  that  a 
patient  study  of  life,  such  as  it  is  given  the  psychoanalyst  to 
pursue,  brings  to  light  yet  deeper-lying  factors,  beside  which 
the  intense  craving  for  self-satisfaction  expressed  in  sex, 
notwithstanding  its  insatiate  affirmation,  is  revealed  as  an 
anomalous  exaggeration— a sporadic  miscarriage  of  affectiv- 
ity  representing  the  distortion  of  an  originally  harmonious 
principle  of  life.  We  think  that  repression  is  the  result  of 
sex.  But  we  are  mistaken.  Sex  is  the  result  of  repression. 
I believe  that  when  child-life  shall  be  permitted  to  develop 
naturally  and  joyously,  its  growth  unfolding  simply  from  the 
harmonious  setting  in  which  life  has  its  inception,  we  shall 
have  gone  far  toward  mitigating  the  driving,  obsessive 
mania  that  now,  whether  covertly  or  frankly,  is  universally 


1 66  Notes  zvith  Reference  to  Freud , Jung  and  Adler 

accredited  under  the  name  of  sex.  The  principle  upon  which 
this  position  is  based  is  embodied  in  my  conception  of  the 
preconscious.3 

Without  this  rudimentary  principle  of  consciousness,  I 
am  utterly  at  a loss  to  formulate  satisfactorily  the  psycho- 
analytic conception  of  sublimation.  Without  this  genetical- 
ly unitary  principle  as  a background  of  consciousness,  what 
are  commonly  called  sublimations  seem  to  me  mere  sub- 
stitutive forms  of  repression,  subsisting  under  the  patronage 
of  social  sanction.  These  socially  acceptable  “sublimations” 
seem  but  cunningly  disguised  forms  of  moral  adaptation. 
They  are  a sort  of  buying-off  of  sex — hush  rewards,  as  it 
were.  And  thus  it  is  sex  again  with  the  cover  thrown  over 
it.  The  informing  principle  is  absent. 

But  after  all,  man  is  new  to  life.  That  sex  or  its 
vicarious  palliations  should  have  become  for  him  the  affirma- 
tion of  existence  is  due  to  the  novelty  and  immaturity  of 
consciousness  itself.  It  is  but  natural  that  having  come 
suddenly  into  the  franchise  of  consciousness,  man  should 
employ  his  liberty  of  action  in  the  wanton  aims  of  personal 
satisfaction,  or  in  the  tedious  propitiations  of  vicarious  con- 
formities. But  there  is  something  deeper  still,  more  native 
to  man,  than  all  this.  It  is  expressed  in  the  social  merging 
of  personalities  into  each  other  in  the  pursuit  of  the  common 
good.  It  is  that  quality  in  man  that  ever  goads  him  to 
search  and  strive  to  the  utmost  benefit  of  the  race.  It  is  this 
quality  of  harmoniousness  and  unity  inherent  in  the  social 
aims  of  man  that  is,  it  seems  to  me,  the  strongest  principle 
of  man’s  consciousness.  This  it  is  that  men  have  called 
love.  This,  it  seems  to  me,  is  the  true  affirmation  of  life 
and  its  prototype  is  the  harmonious  principle  of  the  precon- 
scious. 

I fancy  that  it  was  some  such  perception  as  this  that 
animated  Jung  in  his  divergence  from  the  rigid  scientific 
formulations  of  Freud  with  respect  to  the  sexual  libido.  But 
it  is  unfortunate  that  in  the  pursuit  of  some  such  modification 
as  this,  the  temperamental  quality  in  Jung,  coupled  with  his 
natural  impatience  of  dogmatic  prescription,  should  have 

A “The  Preconscious  or  the  Nest  Instinct,”  read  at  the  7th  Annual  Meeting 
of  the  American  Psychoanalytic  Association,  Boston,  May  25,  1917. 


Trigant  Burrozv 


167 


driven  him  to  exceed  the  bounds  of  moderation  and  have 
lead  him  to  challenge  the  actuality  of  Freud’s  untempered 
observations.  I shall  not  believe  that  the  breach  is  an 
irreparable  one.  It  would  indeed  be  a calamity  if  Jung’s 
genial  perspectives  have  mislead  his  splendid  genius  into  an 
irrevocable  disagreement  with  the  clear,  steadfast,  disinter- 
ested observations  of  Freud. 


III.  The  Adlerian  Concept  of  the  Neuroses 

BY  WILLIAM  A.  WHITE,  M.D. 

Superintendent  of  St.  Elizabeth’s  Hospital , Washington , D.  C. 

ADLER’S  concept  of  the  neuroses  may  be  said  to 
differ  from  the  concepts  of  Freud  and  Jung  in  its 
attempt  to  define  their  organic  bases:  not  that  this 
concept  is  absent  from  either  the  Freud  or  the 
Jung  scheme.  Freud  especially  has  considered  it,  but  Adler 
makes  the  organic  basis  the  basis  of  his  whole  consideration 
of  the  neurosis,  and  the  starting  point  of  his  therapeutic 
attack.  It  may  be  well  briefly  to  recapitulate  Adler’s  views, 
and  to  illustrate  them  in  a way  that  will  show  just  exactly 
how  he  does  this. 

For  Adler  the  fundamental  psychological  element  in  the 
neurosis  is  the  feeling  of  inferiority,  which  feeling  of  inferi- 
ority in  every  case  founds  in  an  inferior  organ.  The  neurosis 
then  consists  in  an  effort  on  the  part  of  the  individual  to 
overcome  this  feeling  of  inferiority,  and  its  outward  signs 
and  symptoms  are  the  manifestations  of  those  dexterities 
developed  to  this  end.  This  is  the  flight  to  safety,  the 
effort  to  overcome  the  feeling  of  inferiority,  and  because 
it  becomes  the  primary  object  of  the  neurotic  it  takes  him 
away  from  reality  on  a false  path.  He  spends  his  life  in 
endeavoring  to  overcome  the  feeling  of  inferiority  rather 
than  in  contact  with  reality.  This  is  the  fictitious  goal  of 
the  neurotic. 

This  concept  can  be  very  much  better  understood  if  it  is 
considered  in  connection  with  and  as  part  of  the  larger  con- 
cept of  progressive  integrations  and  adaptations  as  con- 
stituting the  fundamental  and  developmental  processes.  If 
the  psyche  is  made  possible,  and  in  fact  is  the  expression  and 
the  end  result  of  all  of  the  organic  integrations  which  have 
gone  to  build  up  the  organism,  then  it  must  necessarily 
follow  that  every  defect  in  this  organic  machinery  must 
ultimately  find  its  psychological  expression.  Every  defect 
>of  integration  must  offer  an  obstacle  to  that  orderly  develop- 

168 


William  A.  White 


169 


ment  which  finally  will  present  a well-rounded,  well-balanced 
capacity  for  psychological  reactions,  and  such  a defect  must 
necessarily,  therefore,  modify  the  character  make-up  of  the 
individual.  And  the  way  in  which  that  modification  takes 
place  must  result  from  the  way  in  which  the  defect  is  dealt 
with.  The  defect  may  be  side-tracked  or  circumnavigated, 
as  it  were,  or  it  may  be  assimilated  in  part  or  in  whole,  or  it 
may  be  so  gross  as  to  drag  down  the  individual  to  its  level, 
or  it  may,  by  the  concentration  of  the  efforts  of  the  indi- 
vidual in  this  particular  limited  area,  become  the  center  of 
supernormal  activities,  so  that  the  whole  gamut  from  idiocy 
to  genius,  at  least  from  their  pathological  and  organic 
aspects,  may  thus  be  traced  to  organ  inferiority. 

The  concept  is  a difficult  one,  and  I think  I may  enlighten 
it  by  a further  type  of  illustration  which  I have  found  very 
useful.  For  example,  Adler,  in  explaining  what  he  means  by 
an  inferior  organ  and  the  part  it  plays  in  the  individual 
psyche  would  have  it  that  the  inferior  organ,  so  to  speak, 
hangs  on  to  its  childlike,  infantile,  inferior,  relatively  un- 
developed ways  of  pleasure  seeking,  which,  of  course,  if  we 
understand  by  pleasure  the  fulfillment  of  desire  in  its  broad- 
est way,  can  practically  only  mean  that  the  organ  hangs  on 
to  that  sort  of  capacity  to  function  which  only  is  possible  at 
its  stage  of  development  so  that,  for  example,  the  skin  which 
in  the  polymorphous  perverse  period  of  infancy  is  the  avenue 
through  which  all  sorts  of  comforting  and  organically  deli- 
cious sensations  are  transmitted  to  the  baby,  may  remain 
inferior,  and,  therefore,  in  the  adult  may  continue  as  a source 
of  organic  pleasure  out  of  all  proportion  to  the  part  which  it 
should  play  in  a properly  balanced  picture  of  the  functions 
of  the  adult  considered  in  their  totality.  We  are  familiar, 
of  course,  with  the  exquisite  who  bathes  and  perfumes  him- 
self and  wears  silk  underwear  and  all  that  sort  of  thing, 
because  he  retains  an  autoerotic  gratification  in  cutaneous 
stimulations  which  he  should  have  left  behind  to  have  become 
part  of  his  developmental  history,  but  which  he  has  insisted 
upon  dragging  along  with  him  as  he  grew  to  adulthood.  It 
Is  not  easy  for  us  to  say,  and  I do  not  know  whether  there  is 
an y evidence,  that  such  a skin  is  inferior,  but  this  is  the  way 
in  which  it  would  be  reasoned  out  from  the  Adler  viewpoint, 


170  The  Adlerian  Concept  of  the  Neurosis 

and  if  instead  of  thinking  of  such  a skin  as  I have  described 
it  we  think  of  all  the  possibilities  of  cutaneous  eruptions,  of 
the  various  pruritides  and  so  forth,  we  will  begin  to  under- 
stand how  skin  inferiority  may  play  its  part  in  the  later 
characterological  peculiarities  of  the  individual.  I suggest 
for  consideration  in  this  particular  Sadger’s  illuminating 
article  in  an  early  number  of  the  Jahrbuch.1  You  will  note 
in  studies  of  this  sort  that  whereas  the  actual  mechanism  of 
the  eruption  itself  may  remain  more  or  less  hazy  that  the 
distribution  of  the  lesions  is  of  exceeding  significance,  par- 
ticularly the  pruritides,  the  lesions  of  a senile  eczematous 
variety  and  certain  neurotic  erythemas  and  the  like.  Their 
localization  about  primary  and  secondary  sexual  foci  seems 
to  be  almost,  if  not  quite  conclusive  of  their  intimate 
psychological  affiliations. 

Another  illustration  of  the  same  character — Let  us  take 
for  example,  the  organ  of  hearing;  how  might  we  expect  an 
inferior  organ  of  hearing  to  react  from  the  Adlerian  point  of 
view?  In  the  first  place,  if  the  organ  of  hearing  was  inferior 
we  would  expect  that  it  would  focalize  the  individual’s  feel- 
ing of  inferiority,  in  other  words,  that  his  apprehensiveness 
toward  the  world  of  reality,  his  fear  of  contact  with  actual 
experience  would  tend  to  focalize  in  the  auditory  zone,  and 
if  we  should  trace  back  the  development  of  this  particular 
individual’s  auditory  functioning  we  should  expect  that  it 
would  disclose  a history,  as  I have  already  indicated,  of 
hanging  on,  so  to  speak,  to  infantile  ways  of  pleasure  seeking. 
Now  let  us  begin  at  the  beginning  and  trace  the  history 
through  actording  to  this  theory.  We  would  find  a child  who 
is  enormously  interested  in  auditory  experiences.  Perhaps 
we  might  find  a child  who  had  heard  forbidden  things  in  its 
very  first  years  because  of  the  well-known  association  in  the 
bedroom  of  the  parents.  Later  on  we  might  expect  to  find 
that  such  a child  expressed  his  curiosity  primarily,  of  course, 
sexual  curiosity,  through  his  auditory  apparatus;  that  he 
was  always  listening  and  trying  to  get  information  from  hear- 
ing what  other  people  were  saying.  As  he  grew  to  adulthood 
we  might  expect  such  an  individual,  retaining  the  same  ways 

]Ueber  Haut,  Schleimhaut  und  Muskelerotik. 


William  A.  White 


171 

of  pleasure  seeking,  to  be  perhaps  interested  in  hearing 
obscene  stories  and  jokes.  It  is  to  be  borne  in  mind  that  the 
ambivalent  opposite,  the  suppression  (repression)  of  auditory 
stimuli  is  also  a possible  type  of  reaction.  Such  a person 
might  react  to  obscene  jokes  with  great  emotional  resentment. 
All  the  while  we  might  find  running  along  hand  in  hand  with 
such  a development  a tendency  to  suspicion  of  his  environ- 
ment, which  would  manifest  itself  by  a feeling  of  fear,  appre- 
hension and  anxiety,  in  short  of  inferiority.  If  he  saw  people 
talking  together  in  an  intimate  way  and  could  not  hear  what 
they  said,  from  that  to  the  belief  that  they  were  talking 
about  him  would  be  an  inconsiderable  step  to  take.  And 
so  you  see  we  are  slowly  building  up  here  the  picture  of  a 
paranoiac,  with  his  ideas  of  suspicion,  his  delusions  of  per- 
secution, his  hallucinations  of  hearing.  And  the  hallucina- 
tions of  hearing  of  a paranoiac  in  which  he  hears  people  say 
all  sorts  of  disagreeable  things  to  him  if  interpreted  through 
their  symbolic  significance  will  be  seen  to  represent  the  same 
pleasure  seeking  mechanisms  that  were  openly  manifested 
in  childhood.  This  is  the  sort  of  reasoning  that  we  have 
to  use  to  develop  such  a character  type  as  that  found  in 
paranoia  on  the  basis  of  the  Adlerian  concepts. 

I am  reminded  in  this  connection  of  the  observations  I 
made  some  years  ago  upon  hallucinated  persons,  taking  them 
as  they  came  into  the  hospital,  and  in  looking  over  the  results 
of  those  observations  I was  very  much  interested  to  discover 
that  I never  found  an  hallucinated  patient  with  normal 
sense  organs.  The  ears,  for  example,  showed  some  evidences 
of  an  old  otitis  media,  or  in  older  patients  evidences  of 
sclerosis  and  contraction  of  the  drum  membrane,  diminished 
acuity  of  hearing,  etc.,  etc.  Such  like  evidences  were  found 
also  in  the  other  sense  organs  except  that  in  some  instances, 
and  this  I think  also  extremely  interesting,  in  which  the 
sense  organ  that  was  the  particular  recipient,  so  to  speak, 
of  the  hallucinations  was  healthy,  it  could  be  shown  that 
the  stimulus  for  the  hallucinations  was  derived  from  another 
sense  organ  which  was  not  healthy;  in  other  words,  we  had 
the  phenomenon  of  synsesthesis,  the  first  sensory  change 
occurring  in  a diseased  sense  organ  and  being  manifested  as 
an  hallucination  in  a healthy  one.  One  instance  I recall 


172 


The  Adlerian  Concept  of  the  Neusosis 


particularly  was  an  hallucination  of  smell  which  resulted 
from  the  stimulation  of  a congested  and  swollen  lingual 
tonsil. 

Still  bearing  in  mind  the  general  principle  of  psychical 
integrations  I think  we  must  accept  the  Adlerian  viewpoint 
as  I have  stated.  I think  Adler  himself,  especially  in  his 
work  on  organ  inferiority,  offers  a lot  of  evidence  which  is 
inconclusive,  not  to  say  flimsy  at  times,  or  at  least  is  flimsily 
presented.  It  makes  no  difference,  however,  as  to  whether 
he  happens  to  have  presented  it  well  or  not,  I think  the  con- 
cept must  be  accepted  in  the  way  I have  stated  it.  It  is  a 
concept  which  by  no  means  is  limited  to  the  explanation  of 
certain  character  traits;  it  is  a concept  which  in  its  broader 
significance  compasses  the  whole  field  of  biological  develop- 
ment. Child  has  recently  formulated,  for  example,  a theory 
of  physiological  individuality  in  which  he  defines  individual- 
ity as  all  that  which  may  be  included  under  the  control  of  a 
metabolic  or  dynamic  gradient.  Now  of  course,  the  meta- 
bolic and  the  dynamic  gradient  of  the  human  individual  is 
the  central  nervous  system.  We  may  therefore  consider  all 
that  individual  in  him  which  remains  subservient  to  this 
centralized  authority,  and  just  as  a group  of  cells  may  spring 
into  activity  and  throw  off  the  yoke,  so  to  speak,  of  this  cen- 
tral authority,  set  up  a government  of  their  own,  develop  per- 
haps their  own  independent  dynamic  gradient,  and  become, 
therefore  what  we  call  a tumor,  which  is  really  from  this 
point  of  view  a separate  and,  of  course,  a parasitic  individual, 
so  a sense  organ,  the  eye,  for  example,  may  do  the  same  thing. 
An  eye  which  insists  upon  sticking  to  lower  cultural  levels  of 
pleasure  seeking,  as,  for  example,  the  eye  of  the  young  man 
that  I recently  saw  who  was  arrested  because  he  had  fixed  a 
mirror  on  the  end  of  a stick  and  went  about  the  street  shov- 
ing this  under  women’s  skirts,  a sort  of  periscopic  eye,  the 
eye,  of  such  an  individual  which  continues  to  seek  pleasure  at 
such  cultural  levels  we  may  consider  as  being  in  this  same 
way  an  anarchist  in  its  tendencies  towards  the  total  integra- 
tion, perhaps  not  so  much  the  eye  when  we  are  speaking  in 
psychological  terms  as  what  we  might  better  term  the  eye 
libido.  So,  such  an  individual  is  suffering,  we  might  say, 
from  tumor  of  the  eye  libido.  He  is  suffering  because  his 


William  A.  White 


173 


eye  libido  cannot  be  integrated  with  the  rest  of  his  personality 
and  be  made  subservient  to  the  larger  ends  of  the  individual, 
as  a whole,  but  continues  to  manifest  itself  at  infantile  levels 
of  pleasure  seeking.  It  would  be  interesting,  not  only  to 
examine  such  an  eye  ophthalmologically  for  evidences  of 
inferiority,  but  by  the  Abderhalden  technic. 

This  is  the  Adlerian  concept  as  I see  it,  tome  an  exceeding- 
ly useful  one  and  pragmatically  very  valuable  because  it  serves 
to  bridge  the  gap  between  the  organicists  and  functionalists. 
As  a method  of  approach  to  the  neurosis  I think  that  it  rather 
tends  to  lack  that  capacity  for  individualizing  the  patient’s 
symptoms,  which  is  of  value.  The  organic  part  of  the  situa- 
tion is  of  little  or  no  interest  to  the  patient,  and  in  the  way  in 
which  I have  set  it  forth  here  would,  in  a majority  of  cases, 
be  incomprehensible.  Actual  feelings,  actual  strivings  at  the 
psychological  level,  emotional  trends,  desires,  etc.,  are  the 
things  that  the  patients  can  be  brought  to  understand  be- 
cause they  actually  feel  them.  They  can  be  brought  into 
consciousness  and  dealt  with,  and  in  this  way  the  approach 
along  more  strictly  Freudian  lines  I think  is  more  valuable. 
The  Adlerian  concept,  however,  is  a broad  formulation  which 
is,  to  my  mind,  of  great  scientific  and  philosophic  value  but 
not  of  the  same  therapeutic  value  in  dealing  with  the  indi- 
vidual because  for  the  most  part  one  has  to  deal  with  the 
capacity  for  psychological  readjustments.  The  Adlerian 
concept,  on  the  other  hand,  constantly  reminds  us  that  the 
capacity  for  psychological  readjustment  may  depend,  in  the 
last  analysis,  upon  some  assistance  that  can  be  offered  from 
the  organic  side,  a reminder  which  we  should  take  seriously, 
quite  as  seriously  as  we  believe  the  internists  should  take 
our  suggestions  of  psychogenesis. 


SOME  CRITICISMS  OF  THE  FREUDIAN 
PSYCHOLOGY 


BY  R.  S.  WOODWORTH 
• Columbia  University 

A sufficient  justification  for  the  psychologist  stating 
his  reaction  to  the  psychoanalytic  movement,  even 
though  he  possesses  no  expert  knowledge  of  the 
neuroses,  is  afforded  by  the  Freudian  endeavor  to 
go  behind  the  practice  and  formulate  a psychology  which 
shall  be  true  of  normal  as  well  as  abnormal  conditions. 
This  makes  the  writings  of  Freud  and  his  followers  (and 
competitors)  of  decided  interest  to  psychologists,  who  have 
made  themselves,  I think  it  can  be  said,  fairly  well  acquainted 
with  the  teachings  of  the  school,  and  have  found  there  con- 
siderable that  is  stimulating  and  suggestive.  A number  of 
psychologists,  as  Holt,  Watson,  Wells  and  Lay,  have  es- 
poused the  Freudian  teaching  to  a greater  or  less  extent, 
though  usually  with  considerable  independence  of  judg- 
ment. The  majority,  however,  while  keeping  silence  in  the 
journals,  are  probably  to  be  counted  as  skeptics.  For 
myself  I am  very  skeptical.  I admit  that  a good  deal  of 
stimulus  can  be  derived  from  the  work  of  the  psychoanalysts 
towards  a study  of  neglected  topics  in  psychology;  and  I 
rather  expect  that  many  germs  of  truth  will,  in  the  course  of 
time,  be  found  in  the  teachings  of  this  school;  but  their 
methods,  considered  as  means  of  demonstrating  psycho- 
logical facts,  seem  to  me  excessively  rough  and  ready,  and 
their  conclusions  one-sided  and  exaggerated. 

The  psychoanalysts  have  a handy  rejoinder  to  any  who 
enter  the  lists  against  them.  Having  “complexes"  of  our 
own,  they  say,  which  we  should  not  willingly  admit  and 
which  acceptance  of  Freud’s  point  of  view  would  compel 
us  to  admit,  we  develop  “resistances”  against  that  doctrine. 
In  a special  way,  we  are  prejudiced  against  it  and  are  thus 


174 


R.  S.  Woodworth 


175 


not  equitable  judges.  Now  this  might  be  true  and  still  not 
be  a sufficient  reason  for  disregarding  the  evidence  we  may 
bring  forward.  As  a psychologist,  I probably  do  have  a 
certain  prejudice  against  the  Freudians,  since  they  have 
been  very  contemptuous  of  our  modest  efforts  to  throw  some 
light  on  the  intricate  processes  of  mental  activity  and 
development,  disregarding  what  we  may  have  found  that 
would  bear  on  their  problems,  characterizing  our  efforts  as 
barren  and  superficial,  and  even  going  so  far  as  to  accuse 
us — since  we  must  often  admit  ourselves  unable  to  explain 
a mental  occurrence  except  in  a summary  way — of  holding 
that  such  occurrences  are  events  without  a cause.  In  short, 
they  treat  us  rather  shabbily,  and  I am  willing  to  admit 
a certain  feeling  of  irritation  against  them.  This,  however, 
need  not  throw  me  out  of  court  if  I ask  to  be  heard,  not  as 
an  expert  whose  conclusions  are  to  be  accepted  as  final, 
but,  if  you  will,  as  an  attorney  presenting  one  side  of  a case. 
The  attorney  is  presumed  to  be  biassed,  but  if  he  sticks  to 
evidence  and  legitimate  argument,  his  presentation  of  the 
case  has  to  be  met  by  the  other  side.  His  personality  may 
be  as  full  of  complexes  as  you  please,  but  all  that  is  irrele- 
vant. The  question  is,  whether  the  evidence  can  be  rebut- 
ted; I am  making  bold  to  present  it,  in  part  because  of  a 
feeling  that  the  case  against  Freud  ought  to  appear  in  print 
along  with  the  voluminous  literature  in  his  favor,  and  in 
part  in  the  hope  that  the  psychoanalysts  may  think  it  worth 
their  while  to  consider  this  evidence  and  perhaps,  in  so  doing, 
be  led  to  emendations  or  additions  to  their  doctrine  that 
may  make  it  more  acceptable  to  the  psychologist.  I do 
not,  of  course,  expect  very  much  in  this  direction  from  the 
brief  and  sketchy  presentation  here  to  be  made;  and,  in 
fact,  I expect  much  more  from  the  internal  diversification 
of  view  that  is  beginning  to  appear  within  the  company  of 
those  who  are  or  have  been  pupils  of  Freud.  When  one 
lays  everything  to  “libido”  and  another  everything  to  the 
“masculine  protest,”  it  may  soon  be  recognized  that  both 
of  these  factors,  and  probably  several  others,  are  operative 
in  producing  abnormal,  and  also  normal,  mental  results. 
Meanwhile,  there  is  no  reason  why  the  psychologist  should 
not  also  “do  his  bit”  towards  clarifying  the  situation. 


176  Some  Criticisms  of  the  Freudian  Psychology 

The  first  concern  of  the  psychologist  confronted  with 
the  numerous  assertions  put  forward  by  the  Freudian  school 
is  with  the  methods  employed  to  reach  these  conclusions. 
We  inquire  whether  the  methods  are  reliable.  We  are  not 
concerned  so  much  with  methods  of  treatment  as  with 
methods  of  discovering  facts  and  reaching  psychological 
conclusions.  The  methods  are  primarily  designed  to  analyze 
the  individual,  and  there  seem  to  be  two  of  them,  funda- 
mentally, one  in  which  the  subject  himself  furnishes  the 
analysis  under  the  guidance  of  the  psychoanalyst,  and  the 
other  in  which  the  psychoanalyst  works  with  comparatively 
little  contribution  from  the  subject,  by  the  aid  of  fixed  sym- 
bols. 

The  first-mentioned  method  was  also  the  first  to  be 
employed  by  Freud.  It  starts  from  an  element  of  a dream, 
or  from  a lapse,  or  from  a “complex  indicator”  in  the  free 
association  test;  it  proceeds  by  requiring  the  subject  to  let 
his  mind  move  freely  from  the  starting  point,  without  self- 
criticism  or  reserve;  and  it  terminates,  for  the  moment, 
when  the  subject,  in  the  course  of  this  free  movement  of 
thought,  hits  upon  a “complex.”  Now  so  far  as  the  object 
in  view  is  to  bring  the  complex  to  light,  this  is  all  well  and 
good,  for  if  the  subject  recognizes  and  acknowledges  the 
complex,  once  he  is  reminded  of  it,  it  makes  no  difference 
how  he  has  come  to  it.  But  the  psychoanalyst  is  not  con- 
tented with  simply  drawing  the  conclusion  that  the  subject 
has  the  discovered  complex.  He  goes  on  to  two  other 
assertions. 

He  concludes,  first,  that  arriving  at  the  complex  by 
starting  with  the  dream  or  complex  indicator  means  that  the 
complex  was  at  the  bottom  of  the  dream  or  complex 
indicator.  If  the  subject  has  stumbled  over  a certain  word 
in  the  free  association  test,  and  then,  on  letting  his  mind 
move  freely  from  this  word  as  a starting  point,  has  come  more 
or  less  directly  upon  a certain  complex,  then  the  stirring  of 
that  complex  was  the  cause  of  stumbling  in  the  original  test. 
Or,  if  the  subject  has  dreamed  of  a person  A,  and  on  letting 
his  mind  move  freely  from  the  thought  of  A comes  more  or 
less  directly  to  think  of  a significant  person  B,  then  A in  the 
dream  was  really  a representative  of  B.  By  such  reasoning, 


R.  S.  Woodworth 


1 77 


ostensibly,  the  conclusions  are  reached  that  dreams  have  a 
hidden  meaning  very  different  from  their  manifest  content, 
and  that  lapses  and  hesitations  in  the  process  of  thinking  or 
acting  are  due  to  the  stirring  of  submerged  complexes. 

Now  what  is  the  logic  of  this  inference?  Can  the 
psychoanalyst  seriously  uphold  the  proposition  that,  when- 
ever the  thought  of  A has  come  into  my  mind,  if  I then  let 
my  mind  move  freely  from  A and  reach  B (sooner  or  later), 
B must  have  been  operative  in  making  me  think  of  A in  the 
first  place?  And  how  does  he  know  when  to  stop  in  the 
series  of  thoughts  starting  from  A,  in  order  to  get  the  partic- 
ular idea  or  wish  that  was  unconsciously  at  the  bottom  of 
thinking  of  A?  He  stops,  in  practice,  when  he  finds  a signifi- 
cant complex.  Well  and  good,  if  his  object  is  the  practical 
one  of  discovering  complexes.  But  if  his  object  is  to  dis- 
cover what  led  to  the  thought  of  A (or  to  hesitating  on  A), 
then  what  determines  him  to  stop  just  when  the  complex 
is  reached,  and  not  before  or  after?  It  can  only  be,  as  far 
as  I can  see,  from  a preconceived  notion  that  some  complex 
is  at  the  bottom  of  the  original  thought  or  lapse.  But,  if 
so,  the  Freudian  psychology  is  not  after  all  founded  on  the 
analyses  obtained,  but  upon  preconceived  notions,  or,  per- 
haps it  would  be  better  to  say,  on  the  attractiveness  of  the 
conclusions  reached.  In  other  words,  the  doctrine  of  the 
significance  of  dreams,  lapses  and  other  complex  indicators 
is  not  based  on  the  evidence,  but  upon  a certain  inherent 
attractiveness  of  the  doctrine.  The  statement  is  often 
made  that  Freud  by  no  means  approached  the  matters  he 
examined  with  any  preconceived  notions,  and  that  his 
doctrine  grew  up  in  his  experience;  and  this  may  well  be 
true;  yet  the  doctrine  may  not  have  been  scientifically  de- 
rived from  the  evidence  which  he  brings  forward,  but  may 
have  been  a “happy  thought”  which  occurred  to  him  in 
connection  with  the  cases  he  met  and  so  gripped  him  as 
to  make  evidence,  for  him,  quite  a secondary  matter.  That 
something  like  this  is  true  of  his  followers  is  clear  from  the 
confident  way  in  which  they  approach  new  problems,  sure 
in  advance  that  their  conceptions  will  furnish  the  key,  and 
eager  to  be  satisfied  with  even  the  vaguest  sort  of  evidence. 

But  there  is  more  to  be  said  regarding  the  proposition 


178  Some  Criticisms  of  the  Freudian  Psychology 

that  if  A has  occurred  in  the  process  of  thinking,  then  B, 
reached  from  A as  the  starting  point  of  a free  movement  of 
thought,  is  to  be  presumed  to  have  been  a factor  in  the  orig- 
inal production  of  A.  Freud  somewhere  says  that  it  would 
be  impossible  for  A to  lead  to  B unless  B had  been  operative 
in  the  production  of  A.  This  seems  to  turn  things  topsy- 
turvy, since  what  A arouses  is. conceived  as  arousing  A.  It 
is  contrary  to  the  general  fact  that  shifts  of  thought  are  the 
rule,  so  that  you  tend  to  get  quite  away  from  the  context  of 
your  starting  point  in  the  course  of  a reverie  or  other  free 
associative  process.  And  it  is  contrary  to  the  fact  of  multi- 
ple possibilities  of  associative  reaction.  Thought  may  jump 
hither  or  yon;  it  is  far  removed  from  the  fixed  linkage  of 
stimulus  and  response  characteristic  of  the  simple  reflexes. 
Undoubtedly  there  are  cases  where  thought  hovers  about 
a given  point,  instead  of  passing  off  to  something  else;  but 
shifting  of  the  topic  is  so  characteristic  of  uncontrolled 
thinking  as  to  make  it  utterly  impossible  to  accept  the  funda- 
mental proposition  on  which  the  Freudian  conclusions  as  to 
latent  content  of  dreams,  etc.,  are  supposed  to  be  based. 

If  it  were  possible  to  get  to  the  complexes  only  by 
starting  with  the  dream  or  complex  indicator,  then,  indeed, 
some  special  connection  could  be  believed  to  exist  between 
them;  but,  as  a matter  of  fact,  you  can  take  a perfectly 
arbitrary  starting  point  such  as  a word  occurring  in  the  course 
of  smooth-running  waking  thought,  and,  proceeding  accord- 
ing to  Freud’s  instructions,  reach  a complex  just  the  same. 
Something  of  this  sort  has  been  noticed  by  Freudians,  but 
they  do  not  seem  to  have  observed  that  this  fact  deprives 
their  conclusions  as  to  dreams  and  complex  indicators  of  all 
force.  If  the  complex  is  held  to  have  produced  the  dream  or 
complex  indicator  because,  on  starting  with  the  latter,  the 
former  is  reached,  by  the  same  logic  we  must  conclude  that 
the  complex  operates  in  the  production  of  the  most  smooth- 
running of  waking  thoughts;  and  then  the  distinctions  be- 
tween lapses  and  smooth-running  thinking,  and  between 
dreams  and  waking  thought,  vanish  into  thin  air  and  with 
them  a large  share  of  the  whole  Freudian  psychology. 

I said  that  two  conclusions  were  drawn  from  the  analyses 
beside  the  straight-forward  one  that  the  subject  had  such 


R.  S.  Woodworth 


179 


and  such  complexes,  discovered  by  the  free  movement  of 
thought  from  a complex  indicator  or  dream  element.  The 
first  assertion,  already  examined,  was  that  the  complex  was 
the  underlying  cause  of  the  dream  or  complex  indicator. 
The  second  concerns  the  nature  of  the  complexes  usually 
discovered  and  therefore  concluded  to  be  the  dominant  type 
of  complex  existing  in  individuals,  whether  neurotic  or  sound. 
As  the  procedure  already  described  usually  brings  the  sub- 
ject to  a sexual  complex,  the  prevailing  type  of  complexes 
is  concluded  to  be  sexual.  This  conclusion  would  be  justified 
if  the  movement  of  thought,  which  we  have  hitherto  assumed 
to  be  free,  were  really  as  free  as  at  first  appears.  Psycho- 
logical experimenters  (as  Messer  and  Koffka)  have  frequently 
observed  that  it  is  very  difficult  to  secure  a really  free  asso- 
ciation. Though  the  subject  is  instructed  to  let  his  mind 
move  with  perfect  freedom  from  a given  word  in  any  direc- 
tion, he  inadvertently  specializes  his  task,  or  falls  into  a 
definite  “mental  set,”  so  that  his  reactions  have  a more 
uniform  character  than  would  be  true  were  the  movement 
of  his  thought  wholly  uncontrolled.  The  control  is  not  as 
rigid  as  in  “controlled  association,”  and  is  likely  to  shift 
in  the  course  of  a series  of  associations;  but  such  a thing  as 
absolutely  unguided  movement  of  thought  is  very  unusual. 
Some  interest  gets  at  least  temporarily  in  control,  and  acts 
as  a rudder  to  the  course  of  thinking.  It  is  rather  strange 
that  the  Freudian,  so  insistent  in  the  main  on  underlying 
trends  and  wishes,  should  assume  that  the  subject  is  really 
passive  in  the  process  of  the  analysis,  and  should  omit  to 
inquire  what  sort  of  tendency  or  control  may  be  exerted  on 
the  movement  of  thought.  If  we  ourselves  ask  this  question, 
we  notice  that  the  psychoanalyst  instructs  his  subject  to 
be  passive  and  uncritical,  and  to  give  expression  to  every 
thought  that  comes  up,  no  matter  how  trivial  or  embarrassing 
it  may  be.  The  subject  is  warned  time  and  time  again  that 
he  must  keep  back  nothing  if  he  wishes  the  treatment  to 
succeed.  It  is  easy  to  see  that  such  instructions  tend  to 
arouse  a definite  set  of  mind  towards  that  which  is  private 
and  embarrassing;  and  this  easily  suggests  the  sexual. 
Certainly  one  cannot  be  in  the  hands  of  a Freudian  for  long 
without  becoming  aware  that  sexual  matters  are  of  special 


i8o  Some  Criticisms  of  the  Freudian  Psychology 

interest  and  concern,  and  thus,  if  at  all  responsive,  getting 
a strong  mental  set  in  that  direction.  But  this  state  of 
affairs  shows  the  analysis  in  an  entirely  different  light.  The 
finding  is  no  longer  that  with  a passive  attitude  and  uncon- 
trolled movement  of  thought  sex  complexes  are  predominant- 
ly brought  to  light,  but  that  when  the  subject  is  more  or  less 
subtly  influenced  to  direct  his  thoughts  towards  the  sexual, 
he  comes  upon  sexual  complexes.  The  existence  of  sex 
complexes  is  thus  demonstrated  well  enough,  but  not  their 
preponderance.  If  a psychoanalyst  of  different  convictions 
should  more  or  less  subtly  convey  the  impression  that  the 
important  things  to  look  for  were  in  the  line  of  self-assertion, 
or  in  the  line  of  competition  in  the  struggle  for  existence  and 
social  standing,  or  in  the  line  of  anger  and  irritation,  he 
would  certainly  lead  his  subjects  to  find  complexes  of  these 
types.  There  is  no  doubt  that  complexes  of  all  these  types, 
including  the  sexual,  exist — though  whether  or  not  they  are 
“unconscious”  in  the  Freudian  sense  is  another  question 
which  I shall  not  attempt  to  answer  here — but  as  to  the 
relative  frequency  and  importance  of  the  different  types 
we  have  as  yet  no  clear  indications — certainly  not  from  the 
work  of  the  Freudians. 

The  conclusion  regarding  the  first  method  of  psycho- 
analysis is  that,  though  well  adapted  for  the  discovery  of  sex 
complexes,  it  will  by  no  means  bear  the  weight  of  the  general 
psychological  conclusions  that  have  been  made  to  rest  upon 
it.  The  second  method  may  be  called  that  of  fixed  symbol- 
ism. When  an  element  of  a dream  has  been  decided  to  be 
the  representative  of  something  other  than  itself,  it  can  be 
called  a symbol  of  that  other  thing.  Originally,  Freud 
asserted  strongly  that  such  symbols  must  necessarily  be  an 
individual  matter,  so  that  what  was  signified  by  a given 
symbol  could  only  be  determined  for  an  individual  by  analy- 
sis of  that  individual.  Later,  however,  following  the  lead 
of  some  of  his  pupils,  he  has  come  to  believe  that  certain 
objects  are  fixed  symbols  for  certain  other  objects  or  condi- 
tions, and  that  it  is  no  longer  necessary  to  establish  the 
significance  of  certain  dream  elements  by  the  “free  move- 
ment of  thought”  described  above,  their  significance  being 
known  at  once  from  the  table  of  equivalents  derived  from 


R.  S.  Woodworth 


1 8 1 


previous  psychoanalytic  experience.  For  example,  the 
snake  is  always  a male  phallic  symbol,  a garden  a symbol  for 
the  female  genitals,  and  stairs  a symbol  for  coitus.  These 
and  other  similar  fixed  symbols  are  said  to  hold  good  for  all 
dreams  of  all  persons,  and  also  for  folklore,  myth  and  poetry, 
and  for  reverie  and  much  or  all  of  everyday  thinking — cer- 
tainly for  any  episode  in  thinking  or  acting  that  appears 
“symptomatic”  of  a complex.  These  are  very  broad 
assertions,  and  we  are  nowhere  presented  with  anything 
like  an  adequate  basis  of  recorded  facts  from  which  such 
generalizations  could  be  derived.  One  suspects  a statistical 
error  here,  namely,  the  “error  of  sampling.”  One  suspects 
that  a few  striking  cases,  in  which  a given  symbolism  held 
good,  have  made  so  much  impression  on  minds  predisposed 
to  accept  this  sort  of  thing,  that  the  conclusion  suggested 
has  been  incontinently  generalized,  without  much  pains  to 
look  for  possible  negative  cases  or  much  question  whether 
the  positive  cases  from  which  the  conclusion  was  derived 
are  a fair  sampling  of  all  cases  and  sufficient  in  number  to 
guard  against  error  in  generalization.  It  will  not  help  the 
psychoanalyst,  in  combating  this  criticism,  to  decry  statistics 
and  congratulate  himself  that  he  works  by  no  such  mechani- 
cal method;  for  just  as  soon  as  he  takes  a few  cases  as  rep- 
resentative of  all,  his  abhorrence  of  statistics  will  not  pro- 
tect him  from  the  statistical  error  of  unfair  or  insufficient 
sampling. 

The  doctrine  of  fixed  symbolism  is  inherently  so  im- 
probable as  to  demand  very  thorough  demonstration.  An 
object  becomes  the  symbol  of  another  by  virtue  of  being 
associated  with  it  in  a person’s  experience,  as  is  the  case  with 
words,  mathematical  symbols,  etc.;  or  else  by  virtue  of  some 
similarity  between  the  symbol  and  the  thing  signified. 
Symbols  of  the  first  class  are  certainly  dependent  on  individ- 
ual experience.  If  I have  never  learned  Chinese,  the 
Chinese  character  for  “man”  is  not,  for  me,  a symbol  for 
man.  Symbolism  depending  on  the  similarity  between  two 
objects  can  often  be  appreciated  without  previous  associa- 
tion between  the  two,  as  we  see  in  the  literary  use  of  meta- 
phors. But  where  the  point  of  similarity  is  somewhat 
obscure,  it  may  never  be  noticed  by  an  individual,  and  the 


1 82  Some  Criticisms  of  the  Freudian  Psychology 

symbolic  value  of  one  object  as  representative  of  the  other 
may  accordingly  never  be  actualized  in  him.  For  example, 
the  similarity  of  the  capital  V to  the  number  five,  the  V 
representing  the  hand  held  in  a certain  position,  and  the 
hand  representing  the  number  five,  is  so  indirect  and  un- 
obtrusive that  it  would  scarcely  make  the  one  a symbol  for 
the  other  except  to  an  individual  who  had  been  taught  to 
associate  them.  The  snake,  having  many  different  charac- 
teristics, can  be  looked  at  from  many  different  points  of 
view,  and  only  in  one  of  its  many  aspects  is  it  a phallic 
symbol.  He  who  has  been  accustomed  to  note  others  of  its 
characteristics  will  find  it  a natural  symbol  for  sinuousness, 
or  slyness,  or  wisdom,  or  danger,  and  find  considerable 
difficulty  in  seeing  the  particular  characteristic  that  has 
made  it  a phallic  symbol  to  the  initiated.  The  “garden” 
is,  in  the  experience  of  one  child,  an  ornamental  plot  about 
the  house,  with  grass  and  shrubs  that  require  little  culti- 
vation, while  to  another  it  means  the  vegetable  garden, 
not  ornamental  but  useful,  and  requiring  much  cultivation. 
One  child  is  told  to  “go  and  play  in  the  garden,”  and  the 
other  is  warned  “ not  to  play  in  the  garden.  ” Evidently  the 
garden  will  have  a different  symbolic  value  to  these  two 
children,  and  it  is  improbable  that  either  of  them  will  readily 
catch  the  point  of  the  Freudian  symbolism.  Similar  remarks 
can  be  made  regarding  the  staircase  and  other  supposedly 
fixed  symbols.  Symbolism  is  of  necessity  an  individual 
matter,  dependent  on  particular  associations  established,  or 
on  those  characteristics  of  complex  things  which  have  be- 
come impressed  on  the  individual.  This  is  not  to  deny  in 
the  least  that  the  social  environment  is  influential  both  in 
establishing  arbitrary  associations  in  the  individual’s  mind, 
and  in  calling  his  attention  to  certain  characteristics  of 
complex  objects  and  to  certain  similarities;  and  in  both 
ways  controlling,  to  a large  extent,  the  symbolism  of  the 
individual;  but,  after  all,  the  symbolism  depends  on  in- 
dividual experience,  and  whether  or  not  a given  object  is 
for  an  individual  the  symbol  of  another  can  only  be  deter- 
mined by  study  of  that  individual.  Besides,  the  particular 
symbolism  of  snake,  garden,  staircase,  etc.,  is  by  no  means 
instilled  into  the  child  by  his  social  environment. 


R.  S.  Woodworth 


183 

My  conclusion  is  that  fixed  symbolism,  whether  or  not 
it  may  be  useful  as  a device  for  abridging  the  labor  of  psycho- 
analysis and  still  getting  at  the  sought-for  complexes,  is 
worthless  as  a method  of  scientific  psychology,  and  cannot 
support  the  conclusions  that  are  based  on  it. 

One  further  point  of  method  needs  to  be  examined. 
Since  the  Freudians  have  so  much  to  say  about  the  child, 
and  make  infantilism  a corner  stone  of  their  system,  one  must 
ask  by  what  methods  they  reach  their  knowledge  of  the  child. 
Only  to  a slight  degree  do  they  base  their  conclusions  on 
direct  observation  of  children.  Practically  the  whole  body 
of  their  evidence  is  derived  from  the  reminiscences  of  adults, 
and  of  a selected  class  of  adults,  neurotic  subjects  who  have 
been  psychoanalyzed.  Certainly  this  sort  of  evidence  has 
doubtful  value.  The  matter  is  even  worse  when  we  consider 
the  earliest  years  of  childhood,  to  which  the  memory  of  the 
adult  does  not  reach  back.  From  what  source  is  derived 
the  knowledge  of  the  sexual  and  incestuous  tendencies  of 
babies?  Not,  as  far  as  the  record  shows,  from  direct  study 
of  babies,  nor  from  the  reminiscences  of  adults,  but  apparent- 
ly from  something  akin  to  “fixed  symbolism,”  along  with 
such  knowledge  of  babies  as  every  one  may  be  supposed  to 
possess.  But  I submit  that,  in  order  to  qualify' as  an  expert 
on  child  psychology,  the  psychoanalyst  should  show  a more 
direct  and  concrete  hold  of  the  actualities  of  child  life  than  is 
indicated  by  the  following  citations  from  a book  which  I 
happen  to  have  recently  read. 

“If  we  were  to  watch  a three  months  old  baby  playing 
on  the  floor  we  would  notice  that  it  picked  up  the  objects 
within  reach  and  pretty  generally  thrust  them  immediately 
into  its  mouth.  This  is  done  at  first  indifferently  with 
such  objects  as  a rubber  ball  on  the  one  hand  or  with  the 
baby’s  foot  on  the  other.1 

“The  child  learns,  as  soon  as  it  can  learn  anything,  that 
fecal  matter  is  considered  dirty  and  the  bowel  movements 
in  the  diaper  are  frequently  denominated  a ‘mess’.”' 

The  vagueness  of  knowledge  of  the  time  relations  of  events 

1White,  “Mechanisms  of  Character  Formation:  An  Introduction  to  Psy- 

choanalysis,” New  York,  1916,  p.  180. 

2Ibid.,  p.  200. 


184  Some  Criticisms  of  the  Freudian  Psychology 

in  the  baby’s  development,  revealed  by  these  quotations, 
is  astounding  in  the  representative  of  a school  that  professes 
to  know  so  much  about  children — and  the  time  relations 
are  essential  to  the  author’s  argument  in  both  the  above 
passages.  If  the  psychoanalyst  finds  it  necessary  to  refer 
so  much  to  the  child,  he  should  know  his  child;  and  if  he  finds 
insufficient  information  in  the  books  on  child  psychology — 
as  I can  readily  understand  may  be  the  case — he  should  make 
direct  studies  of  children,  or,  perhaps,  collaborate  with  the 
psychologist  in  the  direct  observation  of  children.  The 
trouble  with  all  the  psychoanalytic  methods  is  their  in- 
directness. Except  that  they  get  at  certain  complexes,  they 
never  furnislr  a direct  view  of  the  facts  which  they  suppose 
to  exist  and  on  which  they  base  their  psychology. 

Even  though  the  methods  of  the  Freudian  psychology 
are  thus  faulty,  the  doctrine  might  still  be  essentially  sound, 
being  based  not  on  the  evidence  brought  forward,  but  on 
great  acumen  in  detecting  the  real  state  of  affairs.  It  may 
be  well  to  take  the  system  as  it  stands,  without  regard  to  the 
manner  in  which  it  has  come  into  existence,  and  examine, 
first,  whether  it  is  internally  coherent.  In  the  main,  it 
certainly  gives  the  impression  of  being  so;  yet  there  are  one 
or  two  respects  in  which  it  seems  to  contradict  itself. 

One  inconsistency  makes  its  appearance  when  we  com- 
pare the  affective  tone  of  the  dream  with  that  of  the  neurotic 
symptom.  The  dream  is  regarded  as  the  equivalent  of  the 
neurotic  symptom,  to  the  extent  at  least  that  both  are  ex- 
pressions of  suppressed  tendencies.  The  apparently  dis- 
proportionate emotion  in  the  neurotic’s  manner  of  dealing 
with  trivial  matters  is  explained  by  saying  that  the  emotion 
has  a genuine  and  adequate  motive.  It  has  simply  become 
secondarily  attached  to  these  trivial  matters;  the  really 
significant  ideas  have  been  suppressed,  but  the  emotion  re- 
mains behind  and  appears  in  connection  with  ideas  that 
have  a symbolic  significance.  Now  the  dream  is  regarded 
as  very  closely  analogous  to  the  neurotic  symptom,  being 
itself  a symbolic  fulfilment  of  suppressed  wishes.  If  this 
conception  of  the  dream  were  sound,  we  should  expect  to 
find  the  dream  heavily  charged  with  emotion;  dreams 
should  be  like  neurotic  symptoms  in  this  respect.  As  a 


R.  S.  Woodworth 


3 


matter  of  fact,  the  dream  is  rather  remarkable  for  its  com- 
parative shallowness  of  emotion.  The  dreamer  is  interested 
in  what  he  is  dreaming  about,  but  is  not  deeply  moved  (ex- 
cept, of  course,  in  the  nightmare).  It  is  very  curious,  if  the 
dream  is  actually  a working  out  of  unconscious  tendencies 
strongly  charged  with  emotion,  that  its  emotional  tone 
should  be  so  mild  and  superficial.  This  could  easily  be 
understood  if  the  dream  were  what  it  seems  to  be,  a relative- 
ly superficial  play  of  fancies,  but  not  if  it  is  as  deeply  motived 
as  Freud  supposes  it  to  be.  We  are  confronted  by  a dilem- 
ma: if  the  suppression  of  a desire  leaves  its  “affect”  free  to 
appear  in  consciousness  attached  to  a symbol,  then  the 
neurotic  symptom  is  explained,  but  the  dream  is  not;  while 
if  the  affect  is  subdued  and  kept  under  along  with  its  ten- 
dency, then  the  dream  is  understandable,  but  not  the 
neurotic  symptom.  There  is  difficulty  in  explaining  both 
phenomena  by  the  same  mechanism. 

Another  internal  inconsistency  in  the  Freudian  psycho- 
logy is  connected  with  the  “censor.”  The  censor,  the  force 
that  suppresses  tendencies  into  the  unconscious,  is  certainly 
essential  to  the  whole  system;  but  whence  comes  the  censor 
with  this  tremendous  power?  He  appears  in  the  drama  as  a 
veritable  deus  ex  machina , not  indeed  setting  everything 
right  at  the  end,  but  initiating  the  conflict  on  which  the 
plot  hinges.  Sometimes  the  censor  is  represented  as  a 
social  compulsion,  sometimes  as  executing  the  mandates  of 
one’s  own  struggle  for  higher  things.  But,  in  any  case,  the 
censor  has  power  enough  to  dominate  the  situation  almost 
completely  in  normal  waking  life,  in  spite  of  the  fact  that 
the  tendencies  which  he  represses  are  so  extraordinarily 
strong  and  pervasive  that  all  activity  is  attributed  to  them; 
that  “man  sexualizes  everything;”  that  myth,  folklore, 
religion  and  even  invention,  according  to  Jung,  are  due  to 
the  energizing  of  these  tendencies;  that  “we  now  know,” 
as  several  psychoanalysts  have  in  substance  said  on  different 
occasions,  “that  man’s  great  activities  are  driven  not  by  the 
superficial  conscious  motives,  but  by  something  much  more 
powerful  and  significant,  working  in  the  unconscious.” 
But  why  are  these  tendencies  unconscious?  Because  they 
are  suppressed.  And  what  keeps  them  suppressed?  The 


1 86  Some  Criticisms  of  the  Freudian  Psychology 

censor;  in  other  words,  tendencies  opposed  to  those  that 
are  suppressed.  The  suppressing  tendencies  must  be 
stronger  than  the  suppressed;  but  where  these  dominating 
tendencies,  personified  by  the  censor,  come  from  and  how 
they  manage  to  suppress  the  all-powerful  and  all-motivating 
unconscious  tendencies,  remains  obscure. 

These  inconsistencies  weaken  the  internal  structure  of 
the  Freudian  system.  It  loses  its  cohesion  and  falls  apart 
into  a number  of  components,  some  of  which  may  be  true 
and  valid,  though  not  all  can  be. 

Space  will  not  allow  consideration  in  detail  of  the 
various  components  making  up  the  Freudian  body  of 
doctrine.  There  is  scarcely  a page  in  the  writings  of  the 
school  that  does  not  contain  assertions  that  arouse  the 
suspicion  of  the  psychologist.  The  ground  of  his  suspicion 
is  usually  about  the  same;  the  exceptional  is  assumed  by -the 
psychoanalyst  to  be  the  regular  thing,  and  the  fascinating 
is  preferred  to  the  more  sober  view,  so  that  in  the  end  a 
highly  distorted  picture  of  mental  processes  and  dynamics 
results.  The  psychologist’s  own  conceptions,  founded  on 
simple  cases  experimentally  studied,  are  much  less  fascinating 
but  are  probably  the  truth  for  the  simple  cases;  and  there  is 
more  hope  of  understanding  the  complicated  cases  by  work- 
ing out  from  the  simple  than  by  resorting  to  poetical  con- 
ceptions for  which  no  genuine  evidence  is  presented. 

Take  the  dream  for  example.  The  invalidity  of  Freud’s 
evidence  for  the  symbolic  significance  of  dreams  has  been 
referred  to  above.  There  is  actually  no  evidence  that 
dreams  in  general  have  a “latent  content”,  or  are  the  ful- 
filment of  deep-seated  and  ordinarily  repressed  wishes. 
Undoubtedly  some  dreams  may  be  fairly  interpreted  in  this 
way;  but  then  there  are  so  many  dreams , and  most  of  them 
yield  a Freudian  interpretation  only  by  forced  and  very 
indirect  procedure.  Meanwhile,  why  should  the  dream 
require  such  deep  motivation?  Granted  that,  as  was  said 
before,  reverie  and  relatively  uncontrolled  thinking  are 
almost  always  steered  by  some  interest,  and  that  the  dream 
is  interesting  to  the  dreamer  at  the  time — this  means  that 
some  interest  is  gratified  by  the  dream-reverie,  but  it  does 


R.  S.  Woodworth 


1 8 7 


not  require  anything  deep-seated  or  extremely  powerful  in 
the  way  of  a motive  force. 

Why  should  a powerful  motive  force  be  required  to 
make  us  dream?  The  associative  mechanisms  are  easy- 
running — this  is  one  of  the  most  obvious  and  certain  facts 
in  psychology,  and  it  is  a fact  which  the  Freudian  school 
seems  resolutely  to  ignore.  If  the  mechanisms  that  give 
us  the  “manifest  content”  of  dreams,  or  of  reveries,  are 
easy-running,  then  sufficient  motive  power  for  them  is 
provided  by  the  relatively  superficial  interests  that  appear 
on  the  face  of  things.  Twenty  years  ago,  before  Freud’s 
work  on  dreams  appeared,  I approached  the  subject  as  a 
student  of  the  late  Professor  James;  and  I was  rather  im- 
pressed by  the  view  of  Ives  Delage,  which  had  a certain 
analogy  to  that  later  developed  by  Freud.  Delage  held 
that  an  object  would  not  be  dreamed  about  if  it  had  been 
dealt  with  to  satiety  on  the  previous  day;  only  those  ten- 
dencies operate  in  the  dream  that  are  not  satisfied  in  the 
daily  life.  At  that  time  I recorded  many  of  my  own  dreams 
and  found  quite  a number  in  which  some  train  of  thought  or 
action,  started  during  the  day  but  broken  off,  was  carried 
further,  whereas  thoughts  or  actions  that  had  been  brought 
to  their  conclusions  and  dismissed  did  not  appear.  In  one 
case  I dreamed  of  getting  a clear  view  of  the  name  on  a 
street  car  that  I had  tried  vainly  to  make  out  during  the 
preceding  day.  Here  we  have  a relatively  superficial 
interest,  though  a genuine  interest,  since  my  curiosity  had 
been  aroused  to  know  whither  a certain  line  of  cars  led;  and 
it  is  quite  probable,  on  the  face  of  it,  that  this  unsatisfied 
curiosity  caused  the  reappearance  of  the  street  car  in  the 
dream.  The  question  is,  whether  we  must  assume  deeper 
lying,  powerful  though  suppressed  tendencies  in  addition  to 
those  that  are  clearly  at  work;  and  the  only  reason  for  any 
such  assumption  would  be  the  conviction,  apparently  en- 
tertained by  the  Freudians,  that  the  mechanism  of  thinking, 
imagining  and  remembering  is  stiff  and  ponderous,  only  to 
be  driven  by  the  big  forces  of  life. 

An  easy-running  mechanism  is  subject  to  interference 
from  slight  disturbing  causes;  and  therefore  it  is  no  more 
necessary  to  invoke  deep-lying  motives  to  explain  lapses  and 


1 88  Some  Criticisms  of  the  Freudian  Psychology 

complex  indicators  than  to  explain  the  occurrence  of  dreams. 
Undoubtedly  some  cases  of  hesitation  or  forgotten  names, 
etc.,  may  be  due  to  the  stirring  of  sleeping  complexes;  but 
we  have  the  best  sort  of  evidence  that  interferences  result 
from  much  more  superficial  factors.  In  a variety  of  ex- 
periments, interference  is  produced  by  associating  two 
responses  separately  to  the  same  stimulus,  the  result  being 
that  the  alternative  responses  interfere  with  each  other  and 
cause  hesitations,  false  responses  and  irritation,  quite 
similar  to  what  is  seen  in  the  “complex  indicator.”  This 
reveals  one  elementary  cause  of  interference,  and  another  is 
brought  to  light  in  the  “color  naming  test.”  Here  we  have 
five  colors  repeated  many  times  in  irregular  order,  and  the 
task  is  to  name  the  colors,  one  after  another,  as  rapidly  as 
possible.  The  five  names  are  absolutely  familiar;  but,  in 
spite  of  this  and  in  spite  of  naming  them  rapidly  and  correct- 
ly most  of  the  time,  momentary  periods  of  confusion  occur 
in  the  course  of  the  test,  with  hesitation,  false  responses, 
confused  utterance,  and  irritation.  The  interference  here 
seems  due  to  “perseveration”  of  the  five  names  so  recently 
and  repeatedly  spoken.  Being  all  in  a condition  of  readiness 
or  easy  excitability,  they  are  likely  to  get  in  each  other’s 
way,  and  make  the  subject  say  “blue”  for  yellow,  or  “grack” 
for  green  or  black.  Another  source  of  confusion  is  the 
anticipation  of  one  reaction  while  another  is  in  progress, 
with  the  result  that  the  two  are  combined  into  a nonsense 
reaction;  and  another  similar  factor  is  the  reacting  to  one 
thing  when  you  intend  to  react  to  another,  the  two  things 
being  both  present  at  once.  Then  there  are  the  natural 
tendency  towards  economy  of  effort,  leading  often  to 
“cutting  corners,”  and  the  opposite  tendency,  when  excited 
or  worried,  toward  excess  of  energy  and  haste.  Lapses  of 
the  tongue,  or  of  the  fingers  in  typewriting,  are  in  general 
readily  explained  by  one  or  another  of  these  simple  mechan- 
isms. Having  then  these  elementary  facts  as  a basis,  the 
psychologist  prefers  to  build  up  from  them  towards  an 
explanation  of  the  more  difficult  cases,  rather  than  to  start 
with  intricate  cases  involving  emotional  disturbance  and 
attempt  to  assimilate  the  simple  cases  to  them. 

As  to  forgotten  names,  Freud  brings  forward  a few 


R.  S.  W oodworth 


189 


striking  though  doubtful  instances,  and  hastily  concludes 
that  all  temporary  inability  to  recall  a fairly  familiar  name 
is  the  result  of  interference  by  a submerged  complex.  He 
fails  to  appreciate  the  great  frequency  and  commonplaceness 
of  this  form  of  lapse.  If  you  start  out  systematically  to 
recall  the  names  of  a large  number  of  familiar  persons  or 
towns,  and  note  carefully  all  the  cases  where  you  are  impeded 
or  get  false  names,  you  will  probably  accumulate  quite  a 
collection  of  cases  in  a few  minutes.  Sometimes  there  is 
but  a momentary  hesitation,  or  an  instantaneous  transition 
from  the  false  name  first  suggested  to  the  true  name;  some- 
times the  period  of  groping  is  more  or  less  prolonged;  and 
sometimes  you  are  quite  unable  to  get  the  right  name  with- 
out giving  up  for  a time  and  starting  afresh  after  an  interval. 
When  study  is  devoted  to  the  false  names  called  up  while 
awaiting  the  right  name,  they  are  found  usually  to  present 
some  degree  of  similarity  to  the  right  name.  They  are 
specially  likely  to  preserve  the  rhythm  and  other  general 
characters  of  the  right  name,  as  well  as  the  initial  sound. 
These  findings  make  it  probable  that  names  are  not  retained 
as  isolated  facts,  but  rather  in  rough  and  ready  classes. 
On  first  hearing  a new  name,  we  assimilate  it  to  names  al- 
ready known,  and  when  later  we  try  to  recall  it,  we  are  likely 
to  get  one  of  the  names  to  which  we  have  assimilated  it 
instead  of  the  exact  name  we  want.  In  other  words  our 
recall  may  be  approximate  instead  of  exact.  Now  when 
we  have  got  thus  on  the  wrong  track  to  some  extent  in  our 
search  for  a name,  we  have  blocked  the  path  to  the  right 
name  by  the  recency  value  of  the  false  names  just  brought 
to  mind.  In  view  of  all  the  facts,  it  is  both  unnecessary  and 
impossible  to  extend  Freud’s  interpretation  of  the  forgotten 
name  to  cover  all  the  cases;  and  it  seems  better  to  start  with 
the  simpler  and  clearer  cases  and  work  out  from  them  toward 
the  more  complex  rather  than  attempt  to  go  the  reverse  way. 
The  Freudian  procedure  is  more  “fascinating,”  just  as 
animism  is  at  first  more  fascinating  than  the  mechanistic 
conception  of  nature;  but  the  mechanistic  conception  “gets 
somewhere,”  and  is  likely  to  have  this  advantage  in  psychol- 
ogy as  well  as  in  physics. 

Just  a word  on  “suppression,”  one  of  the  most  impor- 


190  Some  Criticisms  of  the  Freudian  Psychology 

tant  conceptions  in  the  whole  Freudian  collection.  Here 
again  what  is  striking  and  exceptional  is  extended  to  cover 
simpler  cases.  The  question  is  as  to  what  becomes  of 
tendencies  that  are  not  permitted  to  work  themselves  out 
in  action.  The  only  possibility  recognized  by  Freud  is 
that  the  tendency  is  suppressed  into  the  unconscious,  where 
it  remains  dammed  up,  likely  to  break  out  in  unexpected 
ways.  This  I believe  to  occur  sometimes  (except  that  I 
reserve  judgment  as  to  the  “unconscious”)  both  with  sex 
tendencies  and  with  others,  such  as  those  to  anger.  But 
it  is  not  the  only  thing  that  can  happen.  The  setting  aside 
of  tendencies  to  action  is  something  that  occurs  almost  at 
every  moment  of  the  day,  for  there  are  always  a plurality  of 
stimuli  calling  for  reaction,  and  a selection  must  always 
occur.  But  most  of  the  tendencies  thus  nipped  in  the  bud 
simply  disappear.  And,  in  the  case  of  strong  tendencies 
that  are  not  exactly  nipped  in  the  bud  but  take  hold  of  us 
for  a while,  it  is  still  possible  to  depress  and  weaken  them, 
and  by  repetition  of  this  treatment  so  train  them  to  a sub- 
ordinate position  that  they  may  become  like  rudimentary 
or  atrophied  organs  with  no  practical  effect  on  behavior  or 
feeling.  Thus  the  esthetic  strivings  of  youth  often  become 
atrophied,  and  thus  an  attraction  towards  one  of  the  opposite 
sex  may  become  so  weakened  as  only  to  evoke  a momentary 
regret  or  even  a smile  when  later  it  comes  momentarily  to 
mind. 

Then  there  is  the  “libido;”  and  so  much  has  been 
made  of  this  and  so  much  poor  psychology  spun  about  it  that 
a volume  would  be  required  for  an  adequate  and  detailed 
criticism.  The  same  procedure  on  the  part  of  the  Freudians 
is  visible  here  as  in  the  matters  already  discussed.  They 
choose  a very  special  motive  force,  choosing  it  because  it  is 
interesting  and  “fascinating,”  and  attempt  to  assimilate 
all  the  motive  forces  of  human  activity  to  it — instead  of 
starting,  as  a psychology  of  human  motives  should,  with 
the  more  commonplace  curiosity-manipulation-play-random- 
movement  source  of  activity,  so  dominant  in  children,  so 
much  depended  on  in  education  as  the  source  of  motives  for 
serious  work,  and  so  influential  throughout  life  as  the 
driving  force  in  the  details  of  work  and  play,  however  much 


R.  S.  Woodworth 


191 

the  main  direction  of  affairs  may  be  taken  over  by  the  more 
distinct  motives  of  self-defense,  economic  and  social  aggran- 
dizement, competition,  social  interest,  parental  devotion, 
and  sex.  The  sex  impulse  is  quite  clearly  a specialized 
motive,  and  not  at  all  suited  to  be  taken  as  the  type  of 
all  motives.  The  “sublimation”  of  “libido”,  by  which  it 
becomes  the  motive  force  for  any  activity  whatever,  I be- 
lieve to  be  mostly  a fiction.  What  happens  when  genuine 
libido  is  aroused  is  either  that  it  has  its  own  way  or,  if  not, 
that  it  acts  as  a disturbance  of  any  other  activity  that  is 
attempted.  In  endeavoring  to  distract  himself  from  it  or 
to  resist  it,  indeed,  the  subject  may  get  some  other  motive 
powerfully  aroused  and  so  become  very  active  in  something 
quite  different  from  the  natural  outlet  of  libido.  But  this 
does  not  mean  that  the  motive  force  for  this  second  activity 
is  the  libido  drained  into  another  channel,  any  more  than 
your  resistance  to  one  who  shoulders  you  aside  means  that 
your  motive  in  resisting  is  his  motive  in  pushing  drained  into 
a new  channel;  or,  to  take  a better  example,  any  more  than 
your  intensified  application  to  your  book  when  you  hear 
distracting  noises  from  the  athletic  field,  and  your  resulting 
complete  absorption  in  the  book,  means  that  your  interest 
in  European  history  is  a derivative  of  your  interest  in 
football.  A plurality  of  motives  exists  within  the  individual, 
and  there  is  no  known  reason  for  regarding  them  all  as 
“transformations  of  the  libido.”  The  Freudian  psychology, 
here  as  elsewhere,  becomes  distorted  by  taking  a striking  and 
extreme  case  as  the  type  of  all  others. 

It  would  be  interesting,  as  a sort  of  reductio  ad  ab- 
surdum  of  the  Freudian  system,  to  submit  it  itself  to  psycho- 
analysis, and  interpret  it  in  accordance  with  Freudian 
principles. 

When  we  consider  the  Freudian  psychology  from  the 
psychoanalytic  point  of  view,  we  reach  the  conclusion  that 
the  driving  force  behind  the  invention  of  this  system  is 
“libido,”  that  it  is  itself  a sublimation  of  that  tendency.  If, 
as  Jung  asserts,  the  invention  of  agriculture  and  the  mechani- 
cal arts,  as  well  as  of  myth  and  religion,  is  due  to  the  driving 
force  of  the  sex  instinct — and  in  particular  of  the  incestuous 
tendency — then  we  may  certainly  conclude  that  the  in- 


192  Some  Criticisms  of  the  Freudian  Psychology 

ventions  of  the  Freudians  themselves,  being  so  much  more 
obviously  related  to  sex,  are  driven  by  the  same  force.  The 
element  of  sublimation,  perhaps  not  obtrusive  at  first 
glance,  is  nevertheless  strongly  present  in  the  mental 
activity  that  has  gone  into  the  development  of  the  system. 

Not  only  on  the  side  of  its  authors,  but  also  on  the  side 
of  the  readers  of  Freudian  literature,  the  element  of  sex 
gratification  is  the  main  factor  in  the  spread  of  the  move- 
ment. The  books  owe  their  interest  principally  to  the  sex 
element.  I say  this  on  the  basis,  largely,  of  introspection. 
I have  devoured  many  of  these  writings  greedily,  and  am 
perfectly  aware  that  my  interest  has  been  largely  of  this 
sort,  even  though  I probably  have  more  interest  in  the  other 
elements  present  than  the  majority  of  non-psychological 
readers  would  have.  The  literature  of  the  school  is,  any  one 
must  admit,  extraordinarily  monotonous  when  considered 
from  a purely  objective  standpoint — though  this  is  less  true 
of  Freud’s  own  writings  than  of  most  others  in  the  collection. 
The  same  mode  of  approach  leading  always  to  the  same 
predictable  result — a series  of  riddles,  every  one  of  them 
having  the  same  answer — how  can  such  writings  hold  the 
reader’s  interest?  But  they  do,  or  many  of  them  do.  Now 
I ask  what,  according  to  Freudian  conceptions,  must  be  the 
spring  of  this  interest.  Could  it,  by  any  chance,  be  the  sex 
interest  of  the  reader  that  is  here  tapped?  Is  there  any- 
thing in  the  writings  that  could  awaken  this  interest?  It 
would  not  need,  according  to  the  Freudians,  to  be  anything 
overtly  sexual — is  there  anything  that  could  be  regarded  as 
at  least  symbolically  sexual  in  these  writings?  The  Freudian 
must  certainly  answer  “Yes”  and  conclude  that  in  all 
probability  the  driving  force  in  the  reader’s  attention  is 
“libido.” 

If  we  pass  from  the  doctrines  and  writings  to  the 
practice  of  psychoanalysis,  we  find  a similar  probability, 
still  according  to  the  Freudian  point  of  view.  The  psycho- 
analytic seance  is  a sort  of  coitus  sublimatus,  (sometimes 
homosexual)  both  on  the  physician’s  part  and  on  that  of  the 
patient.  As  far  as  concerns  the  patient,  this  has  already 
been  pointed  out  by  Freudians  in  their  discussion  of  “trans- 
ference. ” On  the  side  of  the  physician,  it  must  be  remarked 


R.  S.  Woodworth 


193 


that  he  is  called  upon  more  than  other  men  to  hold  sex  im- 
pulses in  check,  his  professional  duties  giving  much  occasion 
for  stimulation,  while  his  professional  code  and  his  un- 
doubted fidelity  to  it  restrain  him  from  satisfaction.  Per- 
haps the  neurologist  has  more  occasion  than  most  other 
physicians  to  exercise  constant  censorship  over  himself. 
Now  the  Freudian  conceptions  and  manner  of  treatment 
make  every  patient  interesting  and  give  a form  of  satisfaction 
to  the  suppressed  sex  trends;  and  this  is  evidently — accord- 
ing to  Freudian  principles — the  reason  why  so  large  a 
number  of  neurologists  have  adopted  these  conceptions  and 
methods. 

In  short,  according  to  the  Freudian  line  of  interpreta- 
tion, the  case  of  Freudism  is  perfectly  clear.  It  was  the 
sex  impulse  (perhaps  in  some  obscure  way  incestuous)  that 
impelled  Freud  to  the  creation  of  the  system;  it  is  sex  in- 
terest that  causes  the  books  of  the  school  to  be  read  and  to 
appeal  to  the  reader;  it  is  the  sex  interest  that  leads  a prac- 
titioner to  adopt  the  psychoanalytic  treatment  and  that 
sustains  him  throughout  the  laborious  process  of  analysis; 
and  it  is  sex  interest  on  the  part  of  the  patient  that  insures 
his  cooperation  and  brings  the  relief  that  he  sometimes  de- 
rives from  his  association  with  the  psychoanalyst. 

Though  perhaps  not  all  of  Freud’s  followers  would  have 
the  poise  to  accept  these  deductions  from  their  fundamental 
tenets,  I have  a suspicion  that  Freud  himself  would  not 
shrink  from  this  statement  of  the  case.  He  would  probably 
hold,  and  in  this  I should  wholly  agree  with  him.  that  no 
moral  condemnation  is  involved.  The  sex  impulse  is  not 
to  be  labelled  ignoble  or  unclean — though,  like  other  in- 
stinctive tendencies,  and  perhaps  more  than  most  others,  it 
needs  management  and  may  secondarily  acquire  unclean 
associations — and  the  activities  and  products  resulting  from 
it  are  to  be  judged  on  their  own  merit.  If  sex  interest  on  the 
part  of  the  analyst  and  of  the  patient  furnishes  the  driving 
force  for  the  process  of  treatment,  this  does  not  deprive  the 
results  of  whatever  value  they  may  have  when  judged  on 
their  merits.  The  theory  is  to  be  judged  on  its  merits  as  a 
theory,  and  the  practice  according  to  the  value  of  its  results. 

But  I do  insist  that  this  analysis  constitutes  a reductio 


194  Some  Criticisms  of  the  Freudian  Psychology 

ad  absurdum  of  the  Freudian  theory.  For  if  the  above  were 
anything  more  than  a one-sided  conception  of  the  system, 
and  if  no  independent  and  corrective  motives  such  as 
scientific  curiosity  or  zeal  for  the  welfare  of  neurotic  patients 
entered  in,  then  the  whole  system  would  have  no  more 
authority  or  scientific  value  than  any  other  libidinous 
rhapsody.  I hasten  to  admit  that  I believe  it  to  possess 
more  value  than  that,  for  it  does  without  doubt  contain  the 
elements  of  scientific  curiosity  and  zeal  for  curative  results, 
along  with  a large  dose  of  libido.  It  is  not  void  of  scientific 
value,  but  so  obsessed  is  it  with  a few  elements  in  the  com- 
plex human  personality  that  it  gives  us  a narrow  and  one- 
sided psychology,  utterly  lacking  in  perspective. 

Nor  can  the  success  of  the  treatment — regarding  which 
I do  not  pretend  to  judge — be  used  as  weighty  evidence  in 
favor  of  the  theory.  The  “pragmatic  argument”  will  not 
work  in  this  case.  We  have  a number  of  other  treatments, 
all  more  or  less  successful  in  treating  neurotic  cases,  and 
each  one  purporting  to  be  based  on  a different  theory.  If  the 
psycho-analytic  treatment  could  be  rigidly  deduced  from  the 
Freudian  theory  and  from  no  other  known  theory,  or  even 
if  the  practice  had  originated  as  a deduction  from  the  theory, 
this  argument  would  have  weight.  As  a matter  of  history, 
however,  the  treatment  grew  up  first,  and  the  theory  was 
then  developed  as  a sort  of  rationalization  of  the  treatment. 
The  theory  is  extended  far  beyond  the  needs  of  the  practi- 
tioner. The  psychology  of  the  Freudians,  and  also  their 
views  on  history,  mythology  and  the  world  in  general, 
are  not  essential  to  the  practice,  but  are  to  be  regarded  as 
products  of  the  decorative  art. 


NEED  FOR  A STRICTER  DEFINITION  OF  TERMS  IN 
PSYCHOPATHOLOGY 


BY  MEYER  SOLOMON,  M.  D. 

Chicago 

WITHOUT  preliminary  introductory  remarks  of 
explanation  and  apology,  I shall  plunge  at  once 
into  the  brief  exposition  of  the  topic  chosen  for 
discussion. 

For  non-scientific  purposes  strict  definition  of  terms 
used  in  conversation  may,  perhaps,  not  be  insisted  upon  as  a 
sine  qua  non.  But  this  does  not  hold  for  scientific  disquisi- 
tions and  discussions.  Terms  employed  should  have  a de- 
finite meaning.  They  should  stand,  in  the  minds  of  those 
who  use  them,  for  something  specific,  something  which  can 
be  readily,  quickly,  clearly  defined.  When  terms  cannot  so 
be  defined,  then,  it  seems  to  me,  they  are  not  clearly  under- 
stood, they  do  not  represent  sharpcut  concepts. 

Freud  comes  to  my  aid  in  a very  instructive  passage  in 
his  Psychopathology  of  Everyday  Life  (Brill’s  translation, 
pages  1 1 3-1 14).  Listen  to  his  message:  “A  clear  and  un- 
equivocal manner  of  writing  shows  us  that  here  the  author 
is  in  harmony  with  himself,  but  where  we  find  a forced  and 
involved  expression,  aiming  at  more  than  one  target,  as 
appropriately  expressed,  we  can  thereby  recognize  the 
participation  of  an  unfinished  and  complicated  thought,  or 
we  can  hear  through  it  the  stifled  voice  of  the  author’s  self- 
criticism.”  How  true,  and  yet  how  often  we  fail  to  carry 
into  execution  the  lessons  to  be  learned  by  this  penetrating 
observation  of  Freud!  Would  that  all  of  us  would  take  the 
lesson  to  heart,  and  endeavor,  in  so  far  as  it  is  within  our 
power  and  ability,  to  hold  it  before  us  as  a landmark  or  goal 
in  our  thinking  and  writing.  How  much  better  we  would  be 
understood  1 How  many  misunderstandings  would  be  thus 
averted!  How  many  wars,  wordy  and  bloody,  would  be 
thus  avoided!  And  we  would  be  understood. 


195 


196  Need  for  a Stricter  Definition  of  Terms  in  Psychopathology 

Now,  although  this  truism  applies  in  full  measure  to  all 
fields  of  science,  perhaps  it  applies  with  even  greater  force  to 
newly  developing  fields  of  thought  and  endeavor,  to  new 
branches  of  scientific  sprouting. 

Granted  that  language  is  symbolic,  if  you  so  insist,  that 
it  is  but  a means  of  expression,  of  description,  a relatively 
mechanical,  lifeless  thing  which  must,  however,  forever 
change  with  changing  views  and  broader  understanding. 
Yet,  no  matter  in  what  stage  of  this  progressive  evolution 
of  thought  and  language  we  may  find  ourselves,  we  should 
at  least  expect  that  the  scientific  terms  we  employ,  surelv 
the  most  important  and  most  frequently  used  terms,  should 
stand  for  some  definite,  clearly  expressed,  specifically  outlined 
concepts. 

We  all  know  that  philosophers,  psychologists,  psycho- 
pathologists and  psychiatrists  have  been  accused  of  being 
men  of  words.  They  have  been  said  to  be  long  on  words  and 
much  too  often  short  on  thoughts — at  least  on  clear  thinking. 
This  applies  to  all  of  us.  But  when  the  psychologists  of  the 
socalled  normal  are  today  finding  it  difficult  to  define  the 
limits  or  scope  of  their  science,  to  agree  upon  a definition  of 
“psychology,”  and  when  we  note  the  serious  and  frank 
attempts  being  made  by  the  prominent  psychologists  to 
more  clearly  define  the  terms  they  have  been  employing, 
it  is  high  time  that  we  too,  psychopathologists  and  psychia- 
trists, took  the  hint,  the  lesson,  and  followed  in  their  foot- 
steps, as  many  psychopathologists  of  standing  have  for  some 
time  been  doing,  and  others  indeed  have  long  since  done. 

Nor  shall  we  be  accused  of  hair-splitting  in  our  efforts 
in  this  connection.  It  will  surely  lead  to  clearer  formulation, 
to  better  understanding.  It  will  lead  to  all  of  us  speaking  the 
same  language  more  and  more.  It  will  bring  about  an 
esprit  de  corps , team  work,  all  working  for  the  common  end, 
with  the  same  weapons,  forged  in  the  crucible  of  clear  think- 
ing 

Who  do  I mean  by  all  this?  I mean  simply  this:  Many 
of  the  writers  and  thinkers  in  psychopathology  and  allied 
fields  have  been  employing  terms  year  in  and  year  out,  in 
paper  after  paper  and  book  after  book,  wdthout  giving  us  or 
having  in  their  own  minds  really  clear  concepts  of  which 


Meyer  Solomon 


197 


these  terms  stood  as  symbols  or  representatives.  The  terms 
have  been  accepted  as  such,  with  a vague  meaning  in  the 
mind  of  almost  all  who  employed  them,  and  a tremendous 
superstructure  has  been  built  up  upon  these  terms  as  a 
foundation.  We  may  well  allow  the  following  message  to 
ring  in  our  ears:  Look  to  your  formulations.  Look  to  your 
terminology.  Look  to  your  definitions. 

When  a certain  concept  is  in  a state  of  flux,  of  uncer- 
tainty, of  nebulosity  and  ambiguity,  then  we  may  with 
safety  be  permitted  to  use  a term,  for  the  time  being,  as  a 
peg  on  which  to  hand  the  hat  of  our  cloudy  thinking,  until 
the  problem  has  been  solved  and  clarification  is  in  order. 
But  in  the  meantime  let  us  not  permit  ourselves  to  believe 
or  convince  ourselves  that  we  have  really  solved  the  problem, 
that  the  term  stands  for  a definite,  well-understood  entity, 
and  that  we  can  with  safety  build  farther,  with  utter  disre- 
gard of  the  foundations,  the  fundamentals.  Let  us  be  frank 
enough  to  ourselves  and  to  others  to  declare  openly  that  we 
are  in  a transition  stage,  in  a period  of  uncertainty  and 
progress,  that  we  are  on  the  way  to  clearer  thinking  and 
better  solution  of  the  problem  at  hand,  be  it  what  it  may. 

Take,  for  example,  the  concept  behind  the  name  de- 
mentia precox.  We  know,  at  least  so  it  seems  to  me,  that 
our  concept  of  this  is  most  certainly  vague,  in  spite  of  the 
admirable  progress  that  has  been  made  in  thig  field.  The 
clinical  concept,  the  clinical  delimitation  of  the  particular 
class  of  disorders  which  should  be  called  by  that  name,  if  the 
name  be  employed  at  all,  is  of  a vague  sort.  No  one,  in  the 
present  state  of  our  knowledge  of  this  problem,  can  give  a 
simple,  short,  clearly  understood  and  generally  accepted 
definition  of  what  is  meant  by  the  term  dementia  precox. 
Why?  For  the  simple  reason  that  the  problem  has  not  been 
definitely  solved.  We  are  on  the  road  to  better  understand- 
ing, the  term  is  retained  for  the  present  to  refer  to  a hetero- 
geneous group  of  syndromes  of  many  sorts,  and  in  the  mean- 
time efforts  are  being  made  to  understand  the  conditions  now 
being  denominated  “dementia  precox.”  What  will  even- 
tually happen,  let  us  hope  soon  ? There  will  be  a dismember- 
ment of  the  socalled  dementia  precox  group,  in  accordance 
with  newer  and  better  knowledge  and  understanding.  Then 


198  Need  for  a Stricter  Definition  of  Terms  in  P sxcho  pathology 

the  term  “dementia  precox”  will  probably  be  discarded, 
and  appropriate  names  given  to  the  particular  special  syn- 
dromes or  types  of  reaction  now  being  labelled  by  this  all- 
inclusive  term,  “dementia  precox.” 

Let  me  therefore,  mention  a few  of  the  terms  which 
need  a clearer,  truer,  better  definition  or  delineation. 

The  terms  “neurasthenia”  and  “psychasthenia”  must 
come  in  for  critical  examination.  The  term  “hysteria” 
has  been  considered  by  many.  In  a recent  paper  entitled 
“ On  the  Use  of  the  Term  ‘Hysteria,’  With  a Plea  for  its 
Abolition,  And  a Consideration  of  the  Problem  of  Dismem- 
berment of  Socalled  Hysteria,”1  I made  a feeble  attempt 
to  throw  the  term  “hysteria”  into  the  waste-basket.  Even 
the  terms  “neurosis,”  “psychosis,”  and  “psychoneurosis” 
will  have  to  come  under  our  scrutinizing  eyes  ere  long. 

The  terms  “consciousness,”  “subconsciousness,”  and 
“the  unconscious”  must  be  examined  very  carefully.  The 
unrestrained  employment  of  these  terms  and  the  differing 
concepts  applied  to  them  by  different  authors  has  led  to 
much  confusion — and  it  is  still  going  on. 

In  the  literature  of  the  Freudian  school  we  meet  with 
much  that  needs  better  amplification  and  definition.  The 
Freudians  must  define  in  what  sense  they  use  so  many  of 
their  terms.  The  socalled  “endopsychic  censor”  must  be 
better  explained  or  the  concept  altogether  thrown  aside. 
So  also,  must  they  tell  us  in  what  sense  they  use  the  term 
“repression”  (whether  as  self-conscious  repression,  or  other- 
wise), whenever  they  do  use  the  term — for,  let  us  ever  re- 
member, there  are  all  sorts  of  repression  or  inhibition.  Like- 
wise must  they  explain  themselves  when  they  speak  of  ‘in- 
trapsychic conflict,”  for  here,  too,  there  are  different  types. 
The  terms  “psychological”  and  “psychic”  must  be  juggled 
with  greater  respect.  Furthermore,  the  terms,  “wish,” 
“sexual,”  “libido,”  “horme,”  “will  to  power”  must  pass 
before  us  for  weighing  up.  Even  the  word  “idea,”  since 
it  is  being  used  in  the  phrase  “unconscious  ideas,”  will  have 
to  be  defined  if  we  continue  to  use  this  uncalled  for  phrase- 
ology. The  word  “symbol”  has  been  used  by  many  in  a 

1To  appear  in  New  York  Medical  Journal. 


Meyer  Solomon 


199 


very  peculiar  and  slippery  fashion.  And  so  with  many  other 
terms  used  by  many  of  the  writers  and  workers  in  this  im- 
portant field  of  medico-psychology. 

We  must  by  all  means  avoid  being  accused  of  being 
guilty  of  a play  on  words  which  may  mean  anything  we  wish 
them  to  mean  at  the  particular  moment  at  which  we  are 
weaving  them  into  our  discussions  and  elaborations. 

I doubt  not  that,  when  all  of  us  begin  to  use  the  same 
terms,  with  the  same  ideas  or  concepts  in  mind,  there  will 
be  less  disagreement,  less  misunderstanding,  more  harmony, 
more  good  will,  more  rapid  progress,  and  more  scientific  and 
accurate  observations  and  thinking  in  this  field. 

It  may  well  be  worth  while  to  have  symposia  on  various 
aspects  of  this  problem. 

Has  not  the  psychological  moment  arrived  for  “getting 
together,”  with  better  formulation  and  definition  of  terms 
as  the  object  in  view?2 


2Since  writing  this  little  “plea,”  I have  come  across  Watson’s  paper  on 
“Behavior  and  the  Concept  of  Mental  Disease”  (Journal  of  Philosophy,  Psychol- 
ogy and  Scientific  Methods,  October  26,  1916,  Vol.  XIII,  No.  22)  in  which  he 
criticizes  psychological  and  psychopathological  terminology.  Macdougall  and 
others  have  been  struggling  with  the  same  problem.  See  also  the  instructive 
report  by  Knight  Dunlap  entitled  “The  Result  of  a Questionary  on  Psychological 
Terminology,”  The  Johns  Hopkins  University  Circular,  May,  1916,  No.  5. 


CORRESPONDENCE 

Dr.  Burrow  on  “The  Meaning  of  Psychoanalysis” 

Editor  of  the  Journal  of  Abnormal  Psychology: 

Sir: — 

Dr.  Burrow’s  article  “The  Meaning  of  Psychoanalysis”  in  the 
April-May  number  is  one  to  delight  the  heart  of  an  anti-Freudian. 
While  not  precisely  that,  I do  not  swallow  whole  the  Freudian  con- 
ception of  Art,  Morality,  Life,  and  the  Neuroses  and  Psychoses 
and  so  am  sincerely  pleased  by  such  papers  as  his,  since  they  gratify 
the  egotistic  wish  to  believe  myself  right.  But,  I must  commend 
Dr.  Burrow  for  his  courage  in  expressing  a Nietzchian  scorn  of 
Fear-Morality  in  days  when  all  things  of  Teutonic  stamp  are  un- 
popular. 

“This  fear-inhibition  is  the  active  principle  of  the  universally 
accepted  code  of  behaviour,  commonly  described  as  morality”  is  a 
peculiarly  inadequate  statement,  and  rests  apparently  upon  the 
belief  that  children  are  taught  morality  thru  fear.  As  a matter  of 
fact,  the  real  basis  of  the  acceptation  of  any  code  of  morals  (for 
there  is  no  universally  accpeted  one)  is  the  social  sense  or  instinct, 
the  yearning  to  be  one  with  one’s  fellows,  the  desire  for  praise,  etc., 
positive  factors  of  which  the  fear  of  disapproval  and  punishment  are 
only  the  negative  side.  Nor  is  it  true  that  fear  is  the  all  important 
method  of  teaching  “morality”  to  children.  There  are  many 
homes  in  which  persuasion  and  reward  are  utilized,  though  these 
are  merely  methods  of  reaching  and  activating  the  social  instinct. 
There  are  children  whom  punishment  only  makes  into  rebels,  who 
seemingly  have  no  fear,  but  who  are  melted  into  conformity  by 
kindness. 

Above  all,  has  Dr.  Burrow  never  heard  of  the  imitative  instinct, 
that  great  factor  in  the  development  of  the  child? 

Now  social  codes  do  not  arise  and  did  not  rise  through  Fear. 
It  is  true  Alan  feared  certain  of  the  destructive  aspects  of  nature,' 
but  he  also  loved  the  ground,  the  sunshine,  the  trees,  the  rain,  the 
forces  that  fructify  and  conserve.  Conduct  arose  fully  as  much 
from  his  efforts  to  honor  and  reverence  the  benevolent  forces  as  to 
propitiate  and  avert  the  malevolent.  The  taboo  is  the  product  of 
ignorant  efforts  to  force  and  to  coax  Nature  to  do  his  bidding,  of 
anthropomorphic  conceptions  of  Life.  All  the  sex  restrictions 
arose  through  such  taboos  and  misconceptions,  and  the  conflict 
of  the  promiscuous  sex  instinct  with  the  organized  structure  of 
monogamy  is  merely  another  phase  of  the  battle  between  individu- 
alism and  regulation — not  of  organic-morality  with  fear-morality. 
(Pray  what  is  organic-morality?) 

Now  “if  fear-morality  is  the  stumbling  block  to  the  health  of 
the  nervous  patient  ....  the  sole  recourse  of  psycho- 
analysis is  to  rid  these  invalids  of  their  resistances”  i.  e.  their  fear- 

200 


Correspondence 


201 


morality.  So  since  it  has  been  proven  ad  nauseam  that  the  Oedipus 
complex  is  the  real  basis  of  many  psychoneuroses,  let  us,  logically 
prescribe  incest.  Sodom  and  Gomorrah  will  have  nothing  on  the 
present  day  world  when  it  shall  have  been  made  over  for  the  benefit 
of  the  psychoneurotic.  Meanwhile,  I can  well  see  that  “Specific 
Psychoanalysis,”  the  one  and  holy,  deserves  rank  with  Aviation, 
not  because  of  flightiness  for  they  are  rapidly  perfecting  air-ships, 
but  because  of  the  danger  of  the  profession. 

It  is  true  Dr.  Burrow  has  foreseen,  with  admirable  foresight 
that  “there  immediately  arises  in  the  mind  the  alarming  thought 
of  the  dread  consequences  attending  a mode  of  treatment  which 
should  seek  to  remove  from  a patient  the  safe  guards  of  moral 
inhibition.  Such  a procedure  seems  (emphasis  my  own)  to  threaten 
the  very  foundations  of  morality.”  He  proceeds  to  assure  us  on 
this  point  by  telling  us  that  it  is  only  our  own  foolish  fear-morality 
that  protests.  One  fancies  that  if  Dr.  Burrow  were  a Fire  Com- 
missioner, he  would  reassure  those  who  protested  against  his 
chopping  down  the  Engine  House  by  complacently  assuring  them 
that  they  were  only  afraid  of  Fire! 

As  for  the  rest  of  the  article,  I confess  that  I find  nothing 
startlingly  new  in  the  statement  that  men  believe  that  which  they 
prefer  to  believe.  Neither  do  I see  any  pathogenic  mechanism  in 
that,  since  even  Dr.  Burrow  and  I believe  that  way,  in  common 
with  the  rest  of  mankind.  Nor  do  I know  what  the  “unity  and 
truth,  the  organic-morality,  that  underlies  life”  is.  Won’t  Dr. 
Burrow  please  enlighten  me,  and  the  rest  of  a palpitating  world? 
I fear  there  is  a bit  of  Christian  Science  in  him,  for  he  so  scathingly 
denounces  one  of  man’s  basic  emotions,  Fear.  At  any  rate,  his 
article  means  nothing  unless  he  discloses  his  secret  code  of  morality. 
In  this  world  of  horrid  facts,  phrases  no  longer  help. 

Abraham  Myerson. 


NOTES  AND  CURRENT  EVENTS 


Abnormal  Psychology  no  less  than  Medicine  itself  should 
greatly  profit  by  a revival  among  its  devotees  of  the  historical 
spirit.  Such  a revival  is  promisingly  undertaken  by  the  forthcoming 
Annals  of  Medical  History,  the  plan  of  which  is  set  forth  in  a 
Spring  Announcement,  by  the  publisher,  Paul  B.  Hueber,  of  New 
York. 

The  new  Annals  of  Medical  History  will  be  published 
quarterly;  and  Dr.  Francis  B.  Packard  will  be  the  Editor.  The 
list  of  collaborators  includes  Drs.  Harvey  Cushing,  Abraham 
Jacobi,  Sir  William  Osier  and  others  well  known.  Dr.  Packard 
has  previously  shown  his  interest  in  this  field,  in  connection  with 
the  reprinting  of  Dr.  William  Macmichael’s  famous  sketches  of 
medical  history  known  as  the  “ Gold  Headed  Cane ” (1828).  To 
this  Sir  William  Osier  contributed  an  introduction  and  Mr.  Hueber 
brought  the  same  taste  in  book-making  that  we  may  also  look 
for  in  the  “Annals  of  Medical  History.” 

That  Abnormal  Psychology  was  once  known  as  Morbid 
Psychology  is  curiously  recalled  by  the  announcement  of  an 
article  from  the  pen  of  Dr.  Charles  W.  Burr,  of  Philadelphia,  en- 
titled: “Burke  and  Hare  and  the  Psychology  of  Murder.”  This 
is  to  appear  in  the  Annals  of  Medical  History. 

* * * 

The  historical  shifting  of  emphasis  in  Medical  Psychology  .is 
reflected  in  the  recent  choice  of  topic  for  the  mid-sessional  meeting 
of  the  venerable  Abernethian  Society  of  London,  founded  in 
1 795  by  John  Abernethy  at  St.  Bartholomew’s  Hospital.  By 
request,  the  subject  “ Dreams  and  their  Interpretation ” was  dealt 
with  from  a modern  point  of  view  by  Dr.  Robert  Armstrong-Jones 
of  St.  Bartholomew.  It  is  a topic  which  the  Founder  would  doubt- 
less have  wished  to  approach  from  the  standpoint  of  “disordered 
states  of  the  digestive  organs”  and  to  treat  by  “purging  and  atten- 
tion to  diet,”  in  view  of  his  celebrated  skill  in  these  directions. 

* * * 

The  co-existence  of  the  old  and  of  the  new  order  in  Japan  is 
vividly  portrayed  by  Dr.  Naboru  Ishida  of  Nagasaki,  who  writes  a 
letter  to  the  Editor  of  the  Journal  of  Insanity  (April1)  on  the 
treatment  of  the  insane  in  Japan.  The  writer  reveals  extremes  of 
good  and  of  bad  custodial  care.  On  the  one  hand,  disciples  of 
Krafft-Ebbing,  of  Kraepelin,  or  of  Ziehen  have  had  full  sway  in 


202 


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203 


building  certain  institutions,  establishing  not  only  the  now  familiar 
no-restraint  system,  but  also  the  more  radical  open-door  plan. 
This  is  indeed  more  than  many  institutions  in  this  country 
can  boast  of.  But  on  the  other  hand,  outside  of  this  very  small 
number  of  modernized  hospitals,  medievalism  reigns:  the  insane 
locked  in  dark  cages  attached  to  their  domiciles  or  in  dungeons, 
and  largely  left  to  shift  for  themselves. 

As  to  the  incidence  of  insanity  in  England,  The  Lancet  of 
May  5 expresses  the  idea  that  this  is  not  really  on  the  increase  in 
spite  of  the  prevailing  impression  in  this  matter.  Judging  from 
the  annual  report  of  the  City  of  London  Asylums  this  paper  de- 
clares that  the  War  as  a positive  factor  in  the  insanity  rate  is  not 
demonstrated.  It  seems  that  the  lessened  consumption  and 
especially  the  decreased  abuse  of  intoxicants,  brought  about 
through  war-time  regulation,  operate  to  keep  down  the  incidence. 

* * * 

In  a paper  on  “ Shell-Shock , ” Dr.  Cecil  P.  Smyley,  of  Dublin, 
says:  “One  benefit  that  the  War  has  already  conferred  upon  us  is 
that,  owing  to  the  separation  of  the  officious  nomenclator  from  his 
beloved  lexicon  and  dictionary,  we  have  the  term  shell-shock 
instead  of  some  melodious  and  mouth-filling  word,  such  as  bron- 
teineurotaraxis  ( Bronteion — artificial  thunder,  neuron — nerve,  tara- 
xis — a throwing  into  confusion.)  The  latter  is  really  more  appro- 
priate for  it  seems  hardly  fair  to  crowd  into  two  syllables  the  un- 
numbered symptoms  which  are  grouped  under  the  accepted  title.” 

An  article  in  the  April  number  of  the  Journal  of  Insanity 
carries  the  interesting  conclusion  that  “The  drift  of  opinion  is 
unmistakably  toward  psychogenic  basis  of  war  neuroses  of  all 
types,  including  shell-shock.”  The  article  is  entitled  “ War  and 
Neurosis , ” by  Clarence  B.  Farrar. 

* * * 

What  may  be  called  the  Social  Service  point  of  view  regard- 
ing the  treatment  of  mind-disorders  was  expressed  by  Dr.  Jessie 
Taft,  at  the  fifth  annual  convention  of  the  National  Organiza- 
tion for  Public  Health  Nursing,  in  Philadelphia  in  May. 
“There  is  a blank  wall  of  ignorance  and  prejudice  regarding  mental 
disease  to  be  overcome  which  is  comparable  to  nothing  in  the  field 
of  physical  hygiene”  said  Dr.  Taft,  “The  ordinary  man  has  not,  as 
a matter  of  fact  advanced  very  far  beyond  the  period  of  super- 
stition regarding  mental  diseases.  You  would  have  to  leave  the 
circle  of  the  average  intelligent  citizen  to  find  a person  who  still 


204 


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treats  physical  illness  as  essentially  mysterious— to  be  cured  by 
something  having  no  relationship  to  it,  such  as  magic  or  a charm. 
But  on  the  mental  side  the  average  citizen  is  as  much  a prey  to 
superstition  as  if  he  had  not  been  born  in  a scientific  age.” 

Dr.  Jessie  Taft  is  social  service  director  of  the  New  York 
State  Committee  on  Mental  Hygiene.  This  committee  has 
in  recent  years  taken  on  a closer  relation  to  the  National  Com- 
mittee on  Mental  Hygiene,  in  effect  occupying  the  place  similar 
to  that  of  the  “Mental  Hygiene  Society”  in  other  states  of  the 
Union. 

* * * 

The  May  number  of  the  American  Journal  of  Physiology 
contains  no  less  than  three  separate  papers  by  different  authors 
on  the  adrenal  secretion  and  its  functions.  Physiology  may  be 
said  indeed  to  be  at  present  riding  on  a wave  of  Adrenin,  in  view 
of  the  immensely  increased  prominence  of  this  secretion  in  the 
literature  Physiological  Psychology,  Emotional  States  and  Surgical 
Shock. 

Especially  to  be  noted  among  these  articles  is  one  which 
bears  on  the  purposive  function  of  the  adrenal  secretion:  it  is  by 
Edgar  Allen  Bedford,  entitled,  “ Epinephric  Content  of  the  Blood 
in  Conditions  of  Low  Blood  Pressure  and  ShockC’  This  investiga- 
tion supports  the  idea  that  emergencies  and  physiologic  stress  tend 
to  increase  the  production  and  distribution  of  adrenin  as  an  offset 
to  the  threat  of  low  blood  pressure. 

A new  quarterly  journal  “ E ndocrinology,'!  is  now  in  its  second 
number.  It  is  published  by  the  Association  for  the  Study  of 
the  Internal  Secretions.  The  Secretary  is  Dr.  H.  R.  Harrow- 
er,  of  Glendale,  California.  The  announced  object  of  the  Associa- 
tion is  to  correlate  the  work  and  interests  of  many  physicians  and 
students  throughout  the  world  who  are  interested  in  the  study  of 
the  internal  secretions,  the  endocrine  glands  and  organotherapy. 
The  start  of  the  Association  dates  from  the  early  summer  of  1916. 

* * * 

The  activities  of  the  National  Committee  for  Mental 
Hygiene  are  being  added  to  by  the  publication  of  a new  quarterly, 
“ Mental  Hygiene.  ” 

Dr.  Thomas  W.  Salmon  of  this  Committee,  is  chairman  of  a 
sub-committee  to  furnish  to  the  Government  psychiatric  units  of 
30  to  100  beds  near  the  largest  concentrations  of  troops.  Miss 
Anne  Thompson,  of  Philadelphia,  by  a donation  of  $15,000  pro- 
vides for  the  first  of  such  units;  it  will  be  connected  with  the 
University  of  Pennsylvania  Military  Base  Hospital. 

* * * 


Notes  and  Current  Events 


205 


* A Mental  Hygiene  Clinic  has  been  opened  at  the  San 
Francisco  Polyclinic,  with  Professor  Lillien  J.  Martin  as  psycho- 
pathologist. Prevention  of  mental  ills  as  well  as  treatment  of 
mental  disorder  will  be  the  aim. 

* * * 

Professor  A erkes,  of  Harvard  University,  is  chairman  of  the 
Committee  on  Psychology  recently  appointed  by  the  National 
Research  Council. 

* * * 

Dr.  William  Healy,  formerly  Director  of  the  Juvenile  Psycho- 
pathic Institute  of  Chicago,  is  now  in  charge  of  the  Judge 
Harvey  Baker  Foundation,  a similar  institution  in  Boston. 
Dr.  H.  M.  Adler  will  undertake  functions  in  Chicago  analogous 
to  those  of  Dr.  Healy. 

* * * 

Dr.  Frankwood  E.  Williams,  Executive  Secretary  of  the 
Mass.  Society  for  Mental  Hygiene  has  resigned  and  will  be 
Assistant  Medical  Director  of  the  National  Committee  for 
Mental  Hygiene. 

* * * 

Dr.  John  I.  Wiseman,  who  with  Dr.  Williams  was  formerly 
on  the  staff  of  the  Boston  State  Hospital,  has  become  Assistant 
Physician  at  the  Connecticut  Hospital  for  the  Insane. 


REVIEWS 


THE  NEUROTIC  CONSTITUTION.  OUTLINES  OF  A COMPARATIVE 

Individualistic  Psychology  and  Psychotherapy.  By  Alfred 
Adler.  Authorized  English  translation  by  Bernard  Glueck,  M.  D., 
and  John  E.  Lind , M.  D .,  New  York.  Moffat,  Yard  and  Company, 
1917,  $3.00  net,  pp.  456.. 

There  are  distinct  signs  of  dissension  in  the  Freudian  camp. 
And  as  a result  of  this  intellectualistic  conflict,  we  have  as  offshoots 
of  the  original  and  radical  Freudian  school,  the  group  which  cen- 
ters about  Jung  on  the  one  hand,  and  that  headed  by  Adler  on  the 
other.  This  breaking  away  from  standpatism  is  a healthy  reac- 
tion, and  of  the  two  offshoots  of  Freudian  psycho-analysis  that 
led  by  Adler  is,  it  seems  to  me,  a more  healthy  one  than  that  led 
by  Jung.  And  yet  both  Jung  and  Adler  have  permitted  them- 
selves to  carry  with  them  some  of  the  erroneous  methods  of  think- 
ing and  of  interpretation  which  we  find  so  widely  present  in  true 
Freudism,  as  it  originally  was  and  is. 

It  is  to  be  noted  that  Adler  apparently  does  not  give  the  name 
“ psycho-analysis”  to  his  work.  And  in  this  he  does  well,  since 
the  term  should  have  a limited  connotation  because  of  the  history 
which  centers  abdut  it  as  a nucleus.  In  fact,  Freud  himself,  in  his 
paper  on  “The  History  of  the  Psycho-analytic  Movement”  prac- 
tically reads  both  Jung  and  Adler  out  of  the  psycho-analytic  move- 
ment and  would  not  dignify  their  work  by  the  name  “psycho- 
analysis.” 

It  is  because  he  has  had  the  independence  of  thought  and 
action  to  adopt  his  original  viewpoints  and  cut  himself  adrift  from 
the  original  Freudian  movement  that  one  feels  like  saying,  to 
paraphrase  the  title  of  a recent  popular  song  dedicated  to  our 
president:  “We  take  our  hats  off  to  you,  Dr.  Adler.” 

Adler’s  work  is  a sign  of  progress  in  this  field,  and  if  his  work 
had  no  other  significance,  it  would  be  entitled  to  respect  and  appre- 
ciation for  this  alone. 

To  understand  Adler’s  views  fully,  one  should  read,  as  a speak- 
ing introduction  to  this  volume,  his  “Study  of  Organ  Inferiority 
and  Its  Psychical  Compensation;  A Contribution  to  Clinical 
Medicine,”  translated  by  Smith  Ely  Jelliffe,  as  No.  24  of  the  well- 
known  Nervous  and  Mental  Disease  Monograph  Series. 

In  a brief  introduction  Adler  gives  the  gist  of  his  views,  and 
Dr.  William  A.  White  does  the  same  in  introducing  the  book  to  the 
English-speaking  world. 

There  then  "follow  three  chapters  of  the  theoretical  part  of  the 
work,  in  which  the  author’s  thesis  is  developed,  these  chapters 
dealing  respectively  with  “the  origin  and  development  of  the  feel- 

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207 


ing  of  inferiority  and  the  consequences  thereof,”  “psychical  com- 
pensation and  its  synthesis,”  and  “the  accentuated  fiction  as  the 
guiding  idea  in  the  neurosis.”  The  rest  of  the  book,  comprising  in 
this  practical  part  ten  chapters  totaling  approximately  310  pages, 
deals  with  various  special  aspects  of  the  so-called  neurotic  char- 
acter, such  as  avarice,  suspiciousness,  envy,  cruelty,  desire  to  travel, 
love,  asceticism,  sympathy,  coquetry,  narcissism,  conscience, 
pedantry,  fanatic  attachment  to  truth,  the  derogatory  tendency  to 
disparage  others,  impatience,  discontent,  etc.,  etc.  A final  chapter 
on  “conclusions”  ends  the  work. 

To  really  grasp  Adler’s  views  one  must  read  the  book.  It  is 
long,  there  is  much  repetition,  and  the  thinking  is  frequently  unduly 
complicated,  but  if  one  reads  a chapter  at  a time,  and  then  rereads 
the  book  once  or  twice  carefully,  one  can  get  a good  hold  of  Adler’s 
views. 

For  presentation  of  Adler’s  views  on  organ  inferiority  one 
should  refer  to  the  monograph  above  mentioned,  and  his  views  in 
general  have  been  given  in  English  in  articles  by  Stanley  Hall, 
Amy  Tanner,  Putnam,  Glueck,  Parker,  and  in  a few  other  places. 

It  is  to  be  noted  that,  so  far  as  I know,  Adler  nowhere  gives 
us  a definition  of  the  sense  in  which  he  employs  the  term  “neuro- 
tic.” 

A close  reading  of  his  book,  as  well  as  definite  statements 
made  by  him  here  and  there,  shows  that  to  him  as  to  most  of  us  the 
difference  between  the  so-called  normal  and  the  so-called  neurotic 
individual  is  one  of  degree,  and  that  the  neurotic  merely  presents, 
in  heightened  degree,  the  traits  which  we  find  in  the  normal. 

Adler  lays  his  groundwork  by  postulating  the  existence  in  the 
neurotic  of  organ  inferiority,  the  possession  of  definitely  inferior 
organs  being  in  some  way  (just  in  what  way  this  is  brought  about 
Adler  does  not  indicate  or  prove)  reflected  upon  the  psyche  (which 
is  also  not  defined),  as  a result  of  which  the  so-called  neurotic  per- 
son has  a feeling  of  inferiority  or  of  lowered  self-esteem.  In  order 
to  overcome  this  feeling  of  inferiority  or  insecurity,  and  in  order 
to  attain  a feeling  of  security,  the  neurotic  attempts  to  compensate 
and  in  so  doing  overcompensates  or  goes  to  extremes,  by  the  devel- 
opment of  an  aggressive,  self-assertive  tendency,  taking  as  his 
goal  the  ideal  of  “will  to  power”  which  is  the  will  o’  the  wisp  which, 
unbeknown  to  him,  draws  him  on  and  on,  and  leads  to  all  his 
peculiarities  of  thought  and  action. 

Now,  we  can  go  further  than  this,  by  applying  all  this  to  the 
so-called  normal  person,  who  differs  from  the  so-called  neurotic  in 
degree  only.  Adler  believes,  in  fact,  that  the  very  first  cry  of  the 
newborn  infant  is  a sign  of  the  feeling  of  inferiority  and  insecurity 
or  uncertainty,  and  that  all  subsequent  efforts  of  each  individual — 
all  humanity — are  for  the  purpose  of  avoiding  this  state  of  inse- 
curity and  inferiority  and  of  attaining  a feeling  of  security,  by  the 


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assumption  of  a false  goal  in  life — the  “will  to  power.”  Unreality 
or  phantasy  is,  for  Adler,  at  bottom  nothing  more  than  the  quest 
for  this  false  ideal  of  “will  to  power,”  which,  originally  adopted  as 
the  means  to  the  end  of  security,  is  too  oft  followed  as  an  end  in 
and  for  itself. 

These  are  the  primary  motives  behind  every  effort  of  mankind, 
normal  and  so-called  abnormal.  Hence,  every  thought,  every 
action,  every  trend  of  man,  whether  infant  or  adult,  in  myths, 
dreams,  psychoses,  ordinary  daily  life  or  what  not,  have  these  basic 
driving  forces  behind  them.  And,  besides,  the  individual  has  no 
appreciation  of  the  meaning  of  it  all. 

No  matter  what  the  tendencies  or  ideas  or  conduct  of  the 
individual  may  be,  and  this  applies  in  more  extreme  degree  to  the 
so-called  neurotic,  the  guiding  idea  behind  all  his  efforts  is  the 
“will  to  power”  and  the  attainment  of  security  as  a relief  from  the 
feeling  of  inferiority  and  insecurity. 

This,  then,  is  the  unconscious  motive,  and  for  the  accomplish- 
ment of  this  goal,  all  the  mental  mechanisms  employed  by  Freud 
have  free  play  (although  Adler  does  not  mention  them),  symbolism 
is  used  freely,  and  in  all  other  respects  the  mechanisms  elaborated 
by  Freud  and  his  followers  may  be  employed — -although  Adler  does 
not  specifically  pay  any  attention  in  this  book  to  the  uncon- 
scious and  many  of  the  other  concepts  of  Freud,  except  to  lay 
repeated  stress  on  symbolism. 

All  other  trends,  even  sexuality  in  any  of  its  forms  of  expres- 
sion, are  secondary  to  the  primary  purpose  of  life  mentioned  above, 
and  are  but  used  as  devices  or  means  to  gaining  this  single  goal  of 
life. 

What  more,  if  one  reads  between  the  lines,  and  if  one  pieces 
this  “reading  between  the  lines”  together  with  certain  definite 
statements  made  by  Adler,  his  views  apply  not  only  to  the  activi- 
ties of  human  beings,  but,  with  the  substitution  of  different 
weapons  or  instruments  for  the  attainment  of  this  end,  to  the  life- 
activities  of  animals  and  plants — in  fact,  to  all  manifestations  of 
organized  activity  or  behavior  or  life — to  any  and  every  form  of 
life  from  the  unicellular  type  to  the  most  complicated  human  being. 
This,  then,  as  I see  it,  is  a conception  of  “the  world  as  will  and 
idea.”  This  means  that  Adler  would  have  to  define  in  what  sense 
he  would  use  the  terms  “will”  and  “idea.” 

Furthermore,  Adler,  instead  of  employing  the  term  “will  to 
power”  without  any  qualifications,  employs  many  substitutes. 
He  insists  that  the  so-called  neurotic  constantly  contrasts  in  his 
mind  inferiority  with  superiority,  weakness  with  strength,  being 
“beneath”  with  being  “above,”  being  “down”  with  being  “up.  ’ 
feminine  with  masculine,  woman  with  man,  insecurity  with  secur- 
ity, and  indulges  in  other  similar  antithetical  modes  of  thought. 
And,  still  more,  he  employs  “the  masculine  protest”  as  a sign  of 


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209 


his  “will  to  power.”  Everything  associated  with  feminine  or 
female  the  so-called  neurotic  (whether  male  or  female)  considers 
an  evidence  of  insecurity,  inferiority  and  the  like,  while  the  reverse 
is  in  the  direction  of  his  goal — going  “upward.”  There  is  thus  in 
the  neurotic  a peculiar  condition  of  psychic  hermaphroditism,  but 
this  is  nothing  more  than  an  evidence  of  the  more  fundamental 
struggle  to  avoid  uncertainty,  insecurity,  inferiority,  and  gain  secur- 
ity, certainty,  superiority.  In  this  respect  Adler  indulges  in  a con- 
siderable play  on  words  which  impresses  one  by  its  artificiality  and 
his  stretching  the  point  to  gain  his  end — to  prove  his  case.  . 

In  order  to  gain  his  goal  the  individual  is  apt  to  hurry  things 
and  employ  various  means  to  this  end  as  the  ends  themselves. 
This  occurs  in  the  normal  and  abnormal,  by  day  and  by  night 
(dreams).  Thus  hallucinations,  dreams  (nocturnal),  functional 
psychoses,  all  peculiarities  of  conduct  (any  and  everything,  in  fact), 
are  interpreted  from  this  standpoint.  The  somatic  symptoms 
in  the  psychoneuroses  have  the  same  significance,  for  the  inferior 
organs  are  taken  advantage  of  and  used  for  the  attainment  of  the 
same  goal.  Adler  attempts  to  prove  his  case  by  peculiar  reasoning 
and  far-fetched  analogies.  He  makes  the  error  of  falling  into  the 
trap  of  analogical  thinking  which  he  attributes  to  the  so-called 
neurotic.  He  interprets  things  from  his  viewpoint  and  then  attrib- 
utes these  motives  to  the  so-called  neurotic.  In  this  respect  he 
makes  the  same  error  as  Freud  and  Jung. 

Adler  has  replaced  the  Freudian  sexuality  with  his  new  sys- 
tem of  explaining  the  so-called  neurotic,  in  fact,  all  humanity,  even 
all  life  phenomena  of  whatever  nature,  but  has  permitted  himself 
to  make  the  same  errors  of  thinking  that  we  find  in  the  writings  of 
Freud,  Jung  and  others. 

Of  course,  Adler  expresses  many  truths  throughout  his  work. 
He  sheds  light  upon  the  neurotic  from  many  different  angles.  He 
makes  one  think- — and  think  fast,  too.  But — and  here  lies  the 
danger- — if  you  don’t  think  fast  enough  (or  slowly  enough)  you  are 
swept  off  your  feet  and  accept  all  of  his  views. 

My  advice  to  the  reader  is  to  hold  fast  when  he  gets  aboard 
Adler’s  train. 

The  book  is  very  stimulating  and  thought-provoking,  and 
contains  many  suggestive  viewpoints. 

What  has  been  Adler’s  great  error  of  omission?  Although  at 
times  grasping  the  biological  and  evolutionary  viewpoint  for  a 
moment,  he  immediately  lets  go  of  it,  and  reverts  to  his  favorite 
theme  and  its  tangled  network,  and  tries  to  reduce  all  world- 
phenomena  to  will  and  idea,  but  of  the  specific  type  which  he 
favors  in  this  work. 

Adler  has  missed  the  broad  biological  and  evolutionary  view- 
point. He  has  neglected  the  truly  genetic  viewpoint,  with  a sane 
view  of  phylogenesis.  He  has  failed  to  consider  the  makeup  of 


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man- — his  innate  trends  of  many  sorts,  as  developed  in  some  well- 
known  recent  works  on  this  subject.  Genetic  psychology  has  been 
given  no  consideration.  The  broad  behavioristic  viewpoint,  up 
and  down  the  scale  of  evolution,  has  been  neglected  for  the  most 
part. 

In  spite  of  his  errors  of  omission  and  commission,  Adler  has 
contributed  a work  which  I advise  no  one  to  miss  reading  carefully. 
It  is  of  great  interest,  and  a welcome  rebellion  against  the  purely 
sexual  views  of  the  extreme  wing  of  the  Freudian  psycho-analytic 
movement. 

Adler,  in  spite  of  it  all,  shows  that  he  possesses  a keen  insight 
and  excellent  knowledge  of  the  characteristics  of  the  neurotically 
inclined  individual,  but  his  interpretations  are  too  often  wrong 
and  he  goes  out  of  his  way  too  often  to  reduce  all  tendencies  to 
terms  in  harmony  with  his  rigid  viewpoints. 

Very  valuable  are  his  concepts  of  organ  inferiority,  and  his 
conceptions  of  the  feeling  of  inferiority,  insecurity  and  the  battle 
for  security,  with  the  flights  into  fictitious  goals.  It  applies,  often 
remarkably  accurately,  to  certain  neurotics.  One  will  find  this 
especially  true  of  the  congenitally  neuropathic  and  the  so-called 
psychasthenic  group  of  Janet.  But  is  not  one  going  much  too  far 
when  one  applies  this  interpretation  to  all  cases,  of  whatever 
type,  in  fact  to  all  effort,  all  dynamic  energy?  That  Adler  has 
given  us  an  interesting  viewpoint,  traces  of  the  truth  of  which 
we  can  find  in  any  number  of  normal  and  abnormal  individuals, 
there  is  no  question  whatsoever.  It  is  the  universality  of  the 
application  of  his  ideas  in  this  connection  w'hich  one  must  seriously 
question. 

Furthermore,  Adler  has  considered  organ  inferiority  only.  How 
about  all  sorts  of  other  inferiorities  or  handicaps  or  defects  or 
lacks — call  them  what  one  will — such  as  poor  financial  conditions, 
handicapping  social  status,  paucity  of  opportunities  in  life,  poor 
training  (home,  educational  and  vocational),  etc.  Can  all  these 
causative  factors  which  may  bring  on  a feeling  of  inferiority  and 
insecurity  with  the  sort  of  reaction  Adler  mentions  in  his  book,  be 
reduced  to  terms  of  organ  inferiority?  And  it  must  not  be  for- 
gotten that  Adler  really  means,  or  so  it  seems  to  me,  congenital 
and  too  often  inherited  organ  inferiorities.  This  is  a question 
which  one  can  discuss  at  great  length,  but  it  cannot  be  entered 
into  in  this  place. 

To  critically  discuss  this  book  and  separate  truth  from  fiction, 
one  would  have  to  write  another  book. 

One  can  see  evidences  here  and  there  in  this  work  of  some 
resemblance  between  certain  of  the  views  of  Adler  and  those  of 
others,  such  as  Janet  and  the  French  school,  Bergson,  Jung,  Freud, 
Sidis,  certain  German  philosophic  trends,  and  even  the  behaviorists 
and  neo-animists. 


Reviezvs 


21  I 


This  means  that  there  is  much  truth,  much  of  great  plausi- 
bility, much  that  is  suggestive  and  seductive  in  Adler’s  book. 

Let  us  hope  that  soon  Freudians  and  non-Freudians,  Jung, 
Adler,  Dubois,  Janet,  Prince,  Sidis,  the  other  psychopathologists 
and  with  them  the  psychologists  of  the  so-called  normal  (who, 
themselves,  are  finding  it  difficult  at  present  to  define  “psychology” 
to  the  satisfaction  of  all  of  them),  will  meet  together  on  common 
ground,  speak  the  same  language,  understand  each  other,  and 
work  together  toward  the  common  goal — the  understanding  and 
unravelment  of  the  make-up  of  man.  And  let  this  understanding 
be  built  upon  a broad,  truly  biological  foundation. 

The  mistakes  of  Freud  and  Jung  and  Adler  should  be  lessons  to 
all  of  us  to  go  more  slowly  in  jumping  to  conclusions,  to  avoid  too 
one-sided  interpretations,  to  scrutinize  carefully  the  analogical 
method  of  thinking. 

And,  if,  in  all  this  discussion,  no  personalities  are  injected  and 
all  confine  themselves  to  strictly  scientific  considerations,  it  will 
after  all,  be  well  worth  while.  “All’s  well  that  ends  well.” 

There  are  big  days  in  store  for  psychopathology.  And  may 
they  come  ever  so  quickly. 

The  translators  have  done  remarkably  well  in  their  rendition 
into  good  English  of  a complicated  and  difficult  German.  To  them 
are  due  our  thanks  and  their  well-deserved  meed  of  praise  for  their 
labor. 

Meyer  Solomon. 

mental  conflicts  and  misconduct.  By  William  Healy, 
Director  Psychopathic  Institute , Juvenile  Court,  Chicago.  Boston: 
Little,  Brown  & Company,  1917.  $2.50  net. 

I wonder  whether  any  of  you,  on  reading  this  new  book  by 
Healy,  will  recall  the  lines  of  Joaquin  Miller,  which  I have  seen 
labelled  “The  Dreamers”  at  one  time  and  “Drifting  Souls”  at 
another.  It  is  the  latter  title  which  strikes  me  as  most  suitable, 
especially  a propos  of  the  cases  recited  by  Healy  in  the  book 
before  us.  I give  the  first  two  verses. 

Ah!  there  be  souls  none  understand; 

Like  clouds  they  can  not  touch  the  land, 

Drive  as  they  may,  by  field  or  town; 

Then  we  look  wise  at  this  and  frown, 

And  we  cry,  “Fools,”  and  cry,  “Take  hold 
Of  earth,  and  fashion  gods  of  gold.” 

Unanchor’d  ships,  they  blow  and  blow 
Sail  to  and  fro,  and  then  go  down 
In  unknown  seas  that  none  shall  know, 


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Without  one  ripple  of  renown. 

Poor  drifting  dreamers  sailing  by, 

They  seem  to  only  live  and  die. 

Although  Joaquin  Miller’s  lines  were  intended  by  him  to 
apply  to  a different  group  of  persons  than  those  described  by 
Healy  in  the  volume  under  review,  still  these  lines  do  apply  in  a 
sense  to  these  young  persons  whose  trials  and  tribulations  are 
presented  to  us  by  Plealy,  and  who  are  being  buffeted  about  by 
winds  that  come  too  oft,  they  know  not  whence. 

Like  every  good  book  of  the  sort  before  us,  like  every  work 
dealing  with  the  problem  of  conduct,  behavior,  normal  "or  ab- 
normal, much  could  be  written  in  discussion  of  the  various  aspects 
brought  to  our  attention  by  this  book  by  Healy. 

In  the  preface  Healy  assures  us  that  his  studies  are  tied  to  no 
psychological  school. 

In  his  introduction  the  author  tells  us  that  this  work  is  the 
result  of  several  years  of  observation  of  cases  considered  ample  in 
number  and  watched  sufficiently  long  for  an  estimate  of  the 
ultimate  outcome. 

In  this  book  there  are  considered  cases  in  which,  with  the 
help  of  certain  subconscious  mental  mechanisms,  certain  special, 
active,  dynamic,  hidden  mental  reactions  to  experiences  were 
considered  responsible  for  the  end-result  of  misconduct  of  one 
sort  or  another,  including  whole  careers  of  delinquency.  These 
persons  experienced  an  inner  urge  or  drive  toward  misdoing  which 
was  opposed  to  the  real  conscious  desires  of  the  individual.  In 
most  cases  the  chain  of  causation  was  not  self-perceived  or  self- 
formulated.  The  presence  of  mental  conflict  in  these  cases  is 
shown  by  repressions,  the  escape  of  the  energy  along  undesirable 
lines  and  the  resulting  misconduct. 

The  sexes  were  about  equally  affected.  In  two  series  of  one 
thousand  cases  each  seven  per  cent  of  the  cases  were  found  to  be 
of  this  type — although  many  such  cases  were  no  doubt  missed. 
The  great  need  of  changing  the  environment  in  these  youthful 
patients  after  the  unearthing  of  the  inciting  factors  is  brought 
home  to  us.  On  page  12  is  given  the  list  of  offenses  which  have 
been  found  to  arise  in  some  cases  on  the  basis  of  mental  conflict. 

Three  chapters  of  general  discussion,  entitled  “General 
Principles,”  “Applications”  and  “Methods”  precede  the  presen- 
tation of  specific  case  histories. 

Healy  agrees  with  the  reviewer  that  it  is  best  to  use  the 
phrase  “mental  analysis”  rather  than  the  term  “psychoanalysis” 
when  speaking  of  the  present  analytic  trend  in  psychopathology. 
He  gives  full  credit,  however,  to  the  Freudian  school  for  their 
work,  and  himself  makes  use  of  the  very  helpful  mental  mechan- 
isms developed  by  that  school.  He  justly  says  that  analysis  is 
easier  and  more  direct  in  his  youthful  offenders  than  in  more 


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213 


chronic  psychoneurotics  or  older  habitual  criminals.  He  mentions 
the  types  relatively  unsuited  to  mental  analysis,  and  rightly  asserts 
that  even  in  the  feebleminded  delinquent  it  is  not  enough  to  say 
that  the  offender  is  feebleminded  but  that  it  still  remains  for 
us  to  determine  the  “why”  of  the  recurrent  impulse  to  misconduct 
in  each  particular  feebleminded  individual. 

Practical  hints  for  the  prevention  and  cure  of  these  cases  is 
given  in  the  chapter  on  “Methods.”  By  ordinary  history  taking 
and  cross  questioning  have  the  facts  in  these  cases  been  unearthed. 

Chapters  V to  XV  inclusive  are  devoted  to  the  citation  of 
specific  illustrative  case-histories.  The  headings  of  these  chapters 
are:  Conflicts  accompanied  by  obsessive  imagery,  Conflicts  causing 
impelling  ideas,  Criminal  careers  developed  from  Conflicts,  Cases 
readily  analyzed,  Difficult  cases,  Conflicts  from  sex  experiences, 
Conflicts  from  sex  knowledge,  Conflicts  concerning  parentage  and 
other  matters,  Conflicts  in  abnormal  mental  types,  Conflicts  re- 
sulting in  stealing,  Conflicts  resulting  in  running  away,  Conflicts 
resulting  in  other  delinquencies. 

To  the  psychopathologist  the  most  valuable  contribution  in 
this  work  is  the  series  of  case-histories  offered  for  critical  examina- 
tion, and  the  general  conclusions  of  a practical  nature  plus  the 
application  of  the  modern  analytic  principles. 

In  an  early  chapter  Healy  briefly  discusses  fetishistic  stealing, 
exhibitionism,  voyeurism,  homosexuality  and  other  perversions, 
sadism  and  masochism  as  forms  of  delinquency. 

Sexuality  is  to  be  found  in  almost  every  case,  and  is  the 
direct  causative  factor  in  some  cases  clearly  and  in  other  cases 
less  clearly  distinguished.  It  is  interesting  to  note  how  often  the 
delinquent  who  is  the  victim  of  mental  conflict  learned  about  sex 
affairs  and  stealing  from  the  same  person. 

In  his  final  chapter  of  “Conclusions”  Healy  declares  that  in 
his  group  of  delinquents  as  the  result  of  mental  conflict  abnormally 
unstable  nervous  systems  and  heredity  could  not  be  blamed  in 
the  average  case,  no  special  type  of  character,  temperament  or 
disposition  was  found,  their  general  abilities  range  far  above  the 
average  of  other  delinquents,  and  a summary  of  the  various  mental 
tests  employed  shows  them  to  be  of  no  value  in  getting  to  the 
bottom  of  these  cases. 

Lack  of  proper  parental  control  and  absence  of  close  confiden- 
tial relations  between  parents  and  children  is  a tremendously 
important  factor. 

In  general  it  must  be  said  that  the  book  is  full  of  valuable 
hints  of  a practical  nature  which  can  be  made  use  of  by  all  those 
who  have  to  deal  with  delinquent  offenders  of  the  period  of  adoles- 
cence, puberty  and  earlier. 

It  is  a distinct  contribution  to  criminology  and  the  study  of 
misconduct  in  general,  for  Healy  has  demonstrated  by  actual  case- 


214 


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records  that  mental  conflict  may  lead  to  delinquency  of  varying 
degree. 

It  seems  to  me  that  it  is  probable  that  many  other  types  of 
mental  conflict  than  are  to  be  found  in  the  cases  narrated  in  this 
book  maybe  responsible  for  misconduct.  For  example,  the  prob- 
lem of  school  or  vocational  fitness,  efforts  to  direct  the  energies 
of  the  child  along  the  lines  for  which  he  is  least  fitted  (disabilities) 
with  neglect  of  his  innate  capabilities  is  unquestionably  responsible 
for  a certain  proportion  of  delinquency.  Vocational  problems  are 
more  apt  to  be  in  the  foreground  after  the  working  period  has 
begun.  Healy,  however,  mentions  this  point  in  his  book,  and  I 
understand,  too,  that  a volume  devoted  to  this  very  subject  is  to 
appear  soon  from  the  pen  of  Dr.  Augusta  F.  Bronner,  his  assistant. 

In  going  carefully  over  the  histories  of  the  patients,  especially 
with  respect  to  their  mental  conflicts  and  repressions,  it  is  noted 
that  in  practically  all  the  cases  the  patient’s  memory  for  the  facts 
of  the  conflict  was  good,  he  knew  all  about  it,  and  once  his  attention 
was  directed  to  this  aspect  of  his  trouble  he  was  able  to  give  full 
information  about  it.  Also,  just  preceding  each  act  of  delinquency 
there  was  frequently  a repetition  of  the  same  mental  conflict  which 
was  not  buried.  Here,  as  with  the  psycho-neuroses,  the  afflicted 
one  may  be  entirely  aware  of  the  dynamic  source  of  his  misconduct, 
or  he  may  not  have  critically  examined  or  reflected  upon  or  studied 
the  steps  in  the  evolution  of  his  trouble,  and  so  apparently  knows 
nothing  as  to  its  underlying  source.  In  fact  the  cause  of  the  de- 
linquency is  right  before  us,  on  the  surface,  so  to  say,  for  him  who 
looks  for  it  in  the  right  direction  and  knows  how  or  rather  takes 
time  enough  to  unearth  the  history  in  piece-meal  fashion. 

Healy  adopts  a sane,  rational,  broadminded,  careful  viewpoint 
in  this  matter,  and  he  does  not  allow  himself  to  use  the  mental 
mechanisms  with  a free  hand,  or  to  invoke  the  aid  of  the  all- 
powerful  unconscious,  symbolism,  and  so  forth  in  an  uncritical 
manner. 

He  believes  rather  in  being  long  on  facts  and  short  on  theories, 
especially  of  a too  generalized  and  sweeping  nature.  In  this 
respect  some  may  feel  that  he  has  perhaps  not  made  sufficient 
efforts  to  arrive  at  certain  general  principles  from  a study  of  his 
excellent  material.  Healy,  nevertheless,  has  probably  followed  the 
right  course  in  refusing  to  indulge  in  generalizations  which  may  be 
unfounded  in  this  first  contribution  to  the  subject  of  mental 
conflicts  as  a cause  of  delinquency.  Better  go  slowly  but  surely 
in  this  respect,  since  otherwise  discredit  may  be  thrown  upon  newer 
studies  at  present  in  their  infancy. 

A reading  of  the  various  chapters  in  this  book  will  stimulate 
one  to  deep  thinking  on  his  own  part,  and  each  of  us  will  have 
some  general  truths  flash  up  in  his  mind.  Let  those  who  would 
employ  the  fruit  of  Healy’s  studies  in  this  line  for  the  elaboration  of 
their  own  views,  do  so  to  their  full  satisfaction. 


Rcviezvs  2 1 5 

A lengthy  discussion  could  be  here  entered  into  from  this 
stand-point,  but  it  would  have  to  deal  with  generalities,  reduction 
to  principles,  and  the  like.  And  since  such  discussion  would  apply 
as  well  to  the  psychoneuroses,  alcoholism,  and  other  types  of 
misdirected  energy,  we  may  well  omit  it  in  this  review. 

It  must  be  noted,  however,  that  what  leads  one  person  in  the 
direction  of  legal  misconduct  or  delinquency  or  criminality,  if  you 
please,  may  lead  another  to  alcoholism,  still  another  to  a psycho- 
neurosis, yet  another  to  a full-blown  psychosis  of  the  major  type, 
and  so  on. 

No  one  who  is  interested  in  behavior,  normal  or  abnormal, 
from  the  biological,  psychological  or  sociological  points  of  view, 
can  fail  to  read  this  volume  without  losing  the  benefits,  direct  and 
indirect,  of  the  first  book  attacking  the  so-called  criminal,  better 
called  delinquent  or  misdoer,  from  an  entirely  new  avenue  of 
approach. 

Healy  is  surely  justifying  the  claims  of  the  value  of  the  phy- 
sician (psychiatrist  and  neurologist)  to  society  in  many  ways  not 
yet  dreamed  of  by  a mass  of  the  population. 

Meyer  Solomon. 

WIT  AND  ITS  RELATION  TO  THE  UNCONSCIOUS.  By  Professor 

Dr.  Sigviund  Freud,  LL.  D.  Authorized  English  Edition , with  In- 
troduction by  A.  A.  Brill , Ph.  B .,  M.  D.,  Lecturer  in  Psychoanalysis 
and  Abnormal  Psychology,  New  York  University;  former  chief  of 
Clinic  of  Psychiatry,  Columbia  University,  New  York.  Aloffat, 
Yard  & Company,  1916.  $2.50  net. 

An  abstract  of  this  book  by  Freud  need  not  be  here  given, 
since  his  views  on  this  subject  are  already  known  to  most  of  the 
readers  of  the  Journal  of  Abnormal  Psychology.  In  fact,  Brill, 
in  an  article  in  the  Journal,  which  article  is  included  in  his  “Psych- 
analysis:  Its  Theories  and  Application,”  has  presented,  in  abstract, 
the  views  of  Freud  as  expressed  in  this  work  before  us. 

Of  the  writings  of  Freud 'which  I have  read  carefully,  up  to 
date,  I would  say  that  there  is  less  to  criticize  in  this  work  then  in 
any  of  the  others.  It  is  a distinct  contribution  to  the  psychology 
of  wit  and  its  related  states.  In  fact  it  is  one  of  the  best  works 
wrritten  on  this  subject.  Freud  attacks  the  subject  with  originality 
and  vigor,  he  lightens  up  many  dark  places,  and,  withal,  gives  us  an 
interesting,  stimulating  and  suggestive  volume.  There  is  food  for 
thought  for  future  years  and  years,  in  this  welcome  work. 

Although  Freud  makes  use  of  the  mental  mechanisms  which 
he  so  universally  employs,  this  work  is  distinguished  by  the  fact 
that  while  writing  it  Freud  apparently  forgot  about  his  sexual 
theories,  or  else  he  thought  it  wise  not  to  bring  them  into  the 
foreground.  In  truth,  if  Freud  really  believes  that  his  sexual 
theories  as  applied  to  the  psychoneuroses,  dreams  and  other  con- 


2l6 


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ditions,  are  true  to  form,  then  above  and  behind  or  below  and 
behind  all  other  possible  motives  or  dynamic  sources  responsible 
for  the  production  of  wit  and  its  allies,  we  must  find  hidden  the 
same  old  sexuality  in  the  same  old  forms  as  Freud  has  developed 
them.  In  other  words,  the  pleasure  obtained  in  these  mental 
states,  resulting  from  “economy  in  the  expenditure  of  inhibitions 
or  suppressions,”  must,  in  the  end,  be  reduced  to  sexuality — if 
Freud’s  ideas,  as  expressed  in  some  of  his  other  works,  be  true. 
That  Freud  has  failed  or  has  not  cared  or  dared  to  apply  his  views 
in  full  force  to  wit  and  its  cohort,  is,  it  is  plain,  very  significant. 

Be  that  as  it  may,  we  must  heartily  commend  this  particular 
work,  and  it  goes  without  saying  that  it  should  be  owned  by  all  who 
are  interested  in  Freud’s  views,  and  by  all  who  are  battling  with  the 
problem  of  the  meaning  of  certain  psychic  states  or  trends — wit, 
laughter,  relaxation  in  one  form  or  another,  dreams,  and  a host  of 
other  phenomena. 

Since  Brill,  Freud’s  representative  and  official  translator, 
has  again  done  the  difficult  work  of  rendering  Freud’s  offering  into 
English,  the  English  version  of  this  volume  is  all  that  it  should  be, 
and  the  translation  has  been  done  carefully  and  sympathetically. 

We  may  confidently  bespeak  for  this  volume  a wide  circula- 
tion among  all  sorts  of  people.  Especially  is  this  to  be  expected 
since  Freudian  psychoanalysis  has  broken  out  of  the  ranks  of 
purely  medico-psychological  readers  and  students,  and  has  in- 
vaded the  rank  and  file  of  the  average  reader  and  dabbler  into 
things  literary  and  even  scientific. 

Meyer  Solomon. 


BOOKS  RECEIVED 

JESUS,  THE  CHRIST  IN  THE  LIGHT  OF  PSYCHOLOGY.  By  G. 

Stanley  Hall.  Doubleday,  Page  & Co.  Pp.  XIX  and  733.  2 

vols.  $7.50  net. 

ANTHROPOMETRY  AS  AN  AID  TO  MENTAL  DIAGNOSIS.  By  E.  A. 

Doll.  The  Training  School,  Vineland,  N.  J.  Pp.  91. 

Hindoo  mind  training.  By  An  Anglo  Saxon  Mother.  Long- 
mans, Green  & Co.  Pp.  XXIV  and  536.  $2.75. 

philistine  and  genius.  By  Boris  Sidis.  R.  G.  Badger. 
Pp.  XXVII  and  122.  $1.00  net. 

general  types  of  superior  men.  By  Osias  L.  Szhwarz. 
R.  G.  Badger.  Pp.  435.  $2.50. 

rational  sex  ethics.  By  W.  F.  Robie.  R.  G.  Badger. 
Pp.  356.  $3.50. 

two  studies  in  mental  tests.  By  Carl  C.  Brigham.  Psy- 
chological Monograph  Series.  No.  102,  Pp.  254.  $2.50. 


THE  JOURNAL  OF 
ABNORMAL  PSYCHOLOGY 


VOL.  XII  OCTOBER,  1917  NUMBER  4 


ORIGINAL  ARTICLES 

THE  PSYCHOLOGICAL  CLINIC 

OF 

THE  SOUTHERN  CALIFORNIA  ASSOCIATION 
OF  APPLIED  PSYCHOLOGY 

Reported  by  F.  E.  Owen 

Head  of  the  Department  of  Psychology,  University  of  Southern 

California 

IN  September,  1915,  the  Southern  California  Association 
of  Applied  Psychology,  of  Los  Angeles,  opened  a psycho- 
logical clinic.  This  clinic  was  continued  in  September, 
1916,  in  conjunction  with  the  Department  of  Psychology 
of  the  University  of  Southern  California. 

The  clinical  work  was  conducted  under  the  direction  of 
the  President  of  the  Association,  Miss  Alargaret  Hamilton, 
practicing  psychologist,  who  during  many  years  of  private 
research  and  practice  had  developed  principles  and  methods 
of  psycho-analysis  and  re-education  which  she  has  kindly 
permitted  the  writer  to  discuss  in  the  following  pages.  The 
success  of  our  clinical  work  has  been  due  to  Aliss  Hamilton’s 
generous  contribution  of  time  and  technical  knowledge  and 
skill.  The  writer  makes  grateful  acknowledgment  of  the 
privilege  of  intimate  study  for  the  past  three  years  of  the 
methods  and  principles  used,  and  for  the  opportunity  of 
observing  and  applying  them  in  constant  clinical  demonstra- 
tion during  the  past  year. 

Copyright  iQiy,  by  Richard  G.  Badger.  All  Rights  Reserved. 

217 


218 


The  Psychological  Clinic 


The  aim  of  this  report  is  to  set  forth  the  general  outline 
of  the  problems  that  gave  rise  to  the  ideas  and  technique 
demonstrated  in  the  clinic,  the  range  of  the  clinical  work  done 
and  the  bearing  of  the  methods  and  principles  upon  mental 
hygiene  and  upon  the  more  vital  problems  of  general  educa- 
tion. 

The  record  of  the  progress  of  civilization  may  be  inter- 
preted as  the  story  of  growing  control  attained  through  the 
development  and  control  of  the  mental  life.  Fundamental 
to  the  growth  of  effective  control  of  the  mental  life  is  the 
problem  of  securing  adequate  motivation.  The  sources  of 
motivation  must  be  properly  tapped  in  order  to  make  the 
thought  processes  dynamic,  and  also  in  order  to  give  them 
the  greatest  amount  of  constructive  freedom  in  solving  the 
problems  of  adjustment. 

The  intellectual  processes  which  educational  procedure 
strives  so  hard  to  make  effective  are  under  the  control  of  the 
sources  of  motivation,  the  emotional  and  volitional  life. 
When  these  sources  are  untouched,  intellectual  processes 
fail  to  become  dynamic,  vital,  and  even  the  physiological  pro- 
cesses do  not  function  at  their  highest  and  most  efficient 
potential.  When  these  sources  are  repressed  or  misdirected, 
there  not  only  follows  profound  failure  of  successful  physical 
adjustment,  showing  itself  either  in  various  forms  of  physical 
illness,  or  in  lowered  bodily  efficiency,  but  also,  what  is  still 
more  important,  conduct  guided  by  the  intellectual  pro- 
cesses which  are  called  forth  by  misdirected  or  repressed 
emotional  life  fails  of  the  most  effective  control  in  the  adjust- 
ment process,  or  is  positively  destructive  in  its  program. 

The  place  for  foundational  control  is  thus  to  be  sought 
in  the  emotional  and  volitional  life.  It  is  sound  psychological 
fact  that  out  of  the  heart  are  the  issues  of  life.  Of  this  fact 
man  has  long  been  convinced  although  his  thought  about 
it  has  been  without  sufficient  concreteness  to  give  him  either 
satisfactory  access  to  or  adequate  control  of  the  back-lying 
causes  of  conduct.  We  propose  to  show  that  there  is  a 
simple  and  direct  mode  of  approach  to  these'  back-lying 
causes,  and  a method  by  which  they  may  not  only  be  brought 
to  light  but  dealt  with  successfully  so  that  the  control  for 
which  educational  procedure  seeks  may  be  more  surely 


F.  E.  Owen 


219 


secured  and  human  life  brought  to  a higher  level  of  con- 
structive efficiency  in  meeting  the  problems  of  adjustment. 

No  thoughtful  observer  of  human  life  can  fail  to  be 
impressed  and  deeply  disturbed  by  the  waste  on  all  sides 
that  is  apparent  in  the  large  amount  of  failure  to  meet  suc- 
cessfully and  efficiently  life’s  demands.  In  one  way  and 
another  society  is  carrying  along  a heavy  load  of  those  who, 
for  some  reason,  are  failing  totally  or  in  part  to  contribute 
to  the  full  of  their  capacity  in  caring  for  themselves  and  in 
filling  their  proper  place  in  the  common  tasks  of  human 
progress. 

In  spite  of  the  great  and  effective  advances  in  medical 
science,  in  scientific  methods  of  sanitation,  disease  preven- 
tion and  cure,  we  are  told  that  our  rest-cures,  our  hospitals 
and  sanatoriums,  our  insane  asylums,  our  psychopathic 
institutions  are  full  to  overflowing.  Though  wastage 
through  plagues  of  the  mediaeval  sort  can  never  be  again, 
yet  everywhere  men  and  women  are  suffering  defeat  and 
failure  through  physical  wreckage,  nerve-strain,  over  excite- 
ment, the  modern  rapid  pace  in  the  striving  for  place  and 
power.  Moreover,  the  common  run  of  diseases  are  taking 
their  usual  toll  of  lost  time  and  weakened  bodily  powers,  and 
because  this  state  of  affairs  is  usual,  because  we  are  accus- 
tomed to  so  much  of  human  ill,  we  tend  to  become  calloused, 
to  look  upon  it  as  inevitable,  unavoidable.  “There  has  to 
be  about  so  much  illness,”  we  think,  and  we  go  on  our  way 
submitting  to  what  seems  inevitable  because  it  has  not  yet 
occurred  to  us  that  this  is  one  of  our  problems,  just  as  com- 
monly recurring  epidemics  once  were,  and  that  we  are  taking 
the  same  attitude  of  either  hopelessness  or  indifference 
toward  this  state  of  things  as  was  taken  by  our  less  enlight- 
ened ancestors  toward  plague  ravages.  With  all  our  progress, 
waste  in  various  forms  still  goes  on,  and  to  much  of  it  we  are 
apathetic,  indifferent.  So  long  as  the  machine  keeps  run- 
ning with  some  degree  of  success  we  are  inclined  to  be  con- 
tented. But  from  some  source,  or  sources,  physical  waste  is 
being  propagated  and  continued.  Our  methods  in  the  past 
have  always  been  to  search  for  the  controlling  causes  of  the 
difficulty  and  to  remove  them.  Are  there  causes,  as  yet 
understood  not  at  all,  or  only  imperfectly,  which  we  can 


220 


The  Psychological  Clime 


seize  upon  and  put  under  our  control?  Causes  there  must 
be,  and  only  the  pessimist  would  deny  that  there  are  also 
remedies,  and  that  we  shall  find  them. 

But  the  wastage  is  not  all  primarily  of  the  physical 
sort.  Wastage  through  failure  of  adequate  adjustment  to 
life  shows  itself  in  the  presence  of  poverty,  alcoholism, 
crime,  vagrancy,  delinquency,  and  uncontrolled  sexual  life. 
Here  again,  modern  scientific  method  has  stepped  in,  and 
in  the  form  of  social  surveys  and  social  service  programs 
has  gone  far  towards  discovering  and  relieving  environ- 
mental conditions  which  are  contributory  to  these  forms  of 
waste.  But  while  the  results  obtained  are  gratifying,  we 
must  recognize  the  fact  that  we  have  not  succeeded  in  elimi- 
nating the  evils  to  any  satisfactory  extent.  After  doing  all 
that  can  be  done  for  the  improvement  of  environmental 
conditions,  there  still  remain  the  internal  conditions,  the 
psychological  factors,  which  are  primarily  the  reason  why 
men  and  women  fail  to  meet  the  external  conditions  suc- 
cessfully, and  which  are  at  bottom  the  reason  why  the 
major  portion  of  environmental  social  and  economic  evils 
arise  and  continue. 

It  is  not  a complete  explanation  to  say  that  environ- 
mental conditions  are  unfavorable  to  efficient  living.  We 
must  know  why  the  individual  succumbs  to  the  conditions 
instead  of  surmounting  them,  and  why  these  conditions 
arise  and  are  permitted  to  continue.  It  is  the  common  ex- 
perience of  social  campaigns  that  after  proper  legislation 
has  been  secured,  after  evil  environments  have  been  cleansed, 
many  fail  to  show  any  marked  improvement  in  meeting  the 
responsibilities  of  life,  and  left  to  themselves,  they  soon  drift 
back  into  as  squalid  conditions  as  when  first  the  effort  was 
made  to  help  them  to  higher  levels.  And  we  must  not  be 
blind  to  the  fact  that  wastage,  wreckage  of  the  worst  sort, 
is  by  no  means  confined  to  the  people  living  under  grossly 
improper  environmental  conditions,  but  is  rampant  where 
external  conditions  are  of  the  very  best.  We  are  inclined  to 
ignore  the  failures  among  the  “better  classes”  merely  because 
good  housing,  good  clothes,  plenty  to  eat,  etc.,  give  the 
appearance  of  respectability  to  conditions  of  life  just  as 
evil,  to  failure  in  personal  efficiency  just  as  profound  as  any 


F.  E.  Owens 


221 


found  among  the  poorer  classes  with  their  less  fortunate 
environment. 

The  fact  remains,  that  after  untoward  environmental 
conditions  have  been  given  full  credit,  after  one  has  taken 
proper  account  of  actual  mental  and  physical  deficiencies, 
the  primary  factor  in  the  production  of  economic,  social  and 
moral  failure  is  to  be  found  in  the  life  of  intellect,  emotion, 
and  volition.  And  while  there  must  be  no  cessation  of  our 
every  effort  to  give  men  and  women  and  children  increasing- 
ly better  opportunities  for  a more  abundant  life  by  improv- 
ing the  external  conditions  of  success,  sound  wisdom  directs 
that  the  success  of  our  efforts  to  lift  humanity  out  of  its 
failures,  its  wastage,  will  lie  in  going  to  the  heart  of  the 
matter  by  dealing  more  directly  and  effectively  with  the 
underlying,  fundamental  causes  through  grappling  with  the 
internal,  psychological  factors.  These  factors  are  the  same, 
ultimately,  for  all  human  beings,  whether  we  deal  with  the 
evils  of  our  poor  and  outcast  population,  or  with  the  broken 
lives,  the  inefficiencies  and  failures  of  the  so-called  “upper 
strata”  of  society. 

When  we  face  the  facts  frankly  we  clearly  see  that  our 
sanatoriums  and  asylums,  our  jails,  our  bread-lines  and 
haunts  of  poverty  and  crime  are  the  unsightly  open  sores 
resulting  from  the  exaggerations  of  the  wastage,  of  the  mis- 
directions and  the  perversions  of  human  power  that  are 
present  under  less  evident  and  less  manifestly  disagreeable 
forms  on  all  sides,  among  all  classes  of  people.  We  rub 
elbows  with  this  state  of  things  wherever  we  turn.  Professor 
James  has  said  truly  that  even  the  best  of  us  actually  use 
in  our  constructive  activities  but  a fraction  of  our  energies, 
and  it  is  easily  evident  to  any  observer  that  much  of  the 
power  that  is  used  goes  into  “lost  motion,”  is  not  used 
economically,  represents  strains  and  stresses  and  frictions 
that  are  wasteful  of  energy  which,  if  spent  upon  life’s  ad- 
justments, would  bring  a larger  degree  of  success  in  the  fight. 

The  problem  of  education  might  well  be  described  as 
the  problem  of  the  elimination  of  human  waste  and  the 
liberation  and  direction  of  human  power  at  its  highest 
potential  in  the  most  direct  and  efficient  fashion  upon  the 
problem  of  control:  control  of  individual  powers  and  capaci- 


222 


The  Psychological  Clinic 


ties  and  control  of  environment.  Nowhere  should  we  find 
the  adjustment  process  more  successful,  surely,  than  in  our 
schools  of  higher  education.  And  men  and  women  trained 
in  our  high  schools  and  colleges  may  well  be  expected  to 
show  a higher  degree  of  adequate  adjustment  than  those 
who  have  not  enjoyed  such  opportunities.  By  the  time  the 
student  has  entered  college  a firm  foundation  has  supposedly 
been  well  laid  which  should  insure  his  successful  adjustment 
to  life  as  he  is  to  meet  it  in  its  varied  forms  in  the  higher 
school.  And  yet  there  is  no  teacher  or  parent  who  does  not 
know  that  the  number  of  those  who  go  through  two  or  more 
years  of  college  work  with  more  than  mediocre  success  is 
not  large,  that  many  in  the  school  ranks  are  failing  to  reap 
the  supposed  benefits  of  their  college  life,  that  many  are 
keeping  abreast  of  the  demands  upon  them  at  great  cost  to 
their  energies,  while  partial  or  complete  nervous  and  physical 
breakdown  is  by  no  means  uncommon.  And  many  more 
there  be  who  are  making  moral  failures  in  the  adjustment 
process  which  bring  sorrow  and  loss  in  their  wrake.  After 
all  is  said  in  favor  of  the  greater  success  of  the  school-trained 
individual,  there  remains  this  fact  to  be  faced,  that  large 
numbers  of  our  college-bred  men  and  women  are  to  be  found 
in  the  ranks  of  the  down  and  out,  and  many  more  in  the 
ranks  of  the  mediocre,  the  half-failures,  instead  of  among 
those  who  are  making  constructive,  adequate  contributions 
to  society  as  might  confidently  be  expected  had  their  school 
training  eliminated  the  waste  of  energy  and  brought  their 
powers  to  the  high  degree  of  efficiency  and  control  which  it 
is  supposed  to  do.  In  spite  of  all  that  we  teachers  do  to 
develop  effective  power,  we  succeed  only  partially  with  some, 
and  fail  with  many  more. 

Our  position  is  that  the  reason  for  this  failure  is  not  to 
be  laid  to  general  natural  incapacity  on  the  part  of  the 
student  in  any  large  percentage  of  the  cases,  but  to  causes 
and  conditions  within  the  individual  which  can  be  discovered 
and  eliminated,  and  that  this  discovery  and  elimination  of 
the  causes  for  waste  and  inefficiency  in  the  adjustment 
process,  which  not  only  interfere  with  the  gaining  of  the 
greatest  values  from  the  school  training,  but  which  continue 
to  block  success  all  along  the  way,  constitutes  one  of  our 


F.  E.  Owen 


223 


most  vital  educational  problems.  Properly  understood,  it 
is  basal  to  all  the  rest  of  our  educational  procedure. 

Too  long  have  we  lulled  ourselves  into  academic  an- 
aesthesia by  attributing  the  failures  in  college  life  to  con- 
ditions beyond  our  control  or  outside  our  special  province. 
True,  we  insist,  within  limits,  on  certain  hygienic  measures 
of  exercise,  proper  food,  medical  inspection  and  care.  The 
value  of  as  much  attention  as  this  to  the  purely  physical 
barriers  to  success  is  not  to  be  under-estimated.  And  yet 
every  teacher  knows  that  there  are  many  students  who  give 
due  care  and  attention  to  all  these  matters  of  good  physical 
regime,  and  yet  who  do  not  seem  to  generate  thereby  the 
physical  vigor  necessary  to  carry  them  along  through  the 
stress  and  strain  of  hard  and  persistent  application  with  ease 
and  buoyancy  and  efficiency.  But  we  have  formed  the 
habit  of  avoiding  all  responsibility  by  laying  this  state  of 
things  to  the  “natural”  incapacities  of  the  student’s  physical 
machinery.  Such  students  we  say  are  “naturally  not 
strong,”  they  are  “frail,”  “delicate,”  “high  strung;”  they 
are  “overworking,”  “of  nervous  temperament,”  etc.,  ad 
nauseam  as  though  to  give  ourselves  over  to  manufacturing 
vague  terms  brought  a satisfactory  solution  or  explanation 
of  the  difficulty.  When  we  have  covered  over  the  problem 
with  a vain  show  of  words,  and  have  relegated  the  difficulty 
thereby  either  to  the  realm  of  native  incapacity  mentally,, 
or  to  physiological  imperfections,  we  are  satisfied  that  it  is 
outside  our  jurisdiction,  it  is  not  our  affair,  but  belongs,  for 
correction,  to  the  physician. 

The  truth  is  that  there  is  much  physical  waste  and 
inefficiency  and  ill-health  that  cannot  be  laid  to  the  door  of 
wrong  diet,  insufficient  exercise,  irregular  hours,  or  the 
incursions  of  various  diseases.  And  there  is  also  much 
mental  waste  and  inefficiency  that  cannot  be  laid  to  mere 
native  incapacity,  physical  or  mental,  as  the  primary  cause. 
It  was  the  conviction  that  the  causes  of  failure  to  meet  life’s 
demands,  as  outlined  in  the  preceding  paragraphs,  are  to 
be  found  primarily  in  the  mental  life,  and  that  these  causes 
can  be  discovered  and  controlled  by  psychological  methods, 
which  led  Miss  Hamilton  to  the  discovery  and  development 
of  the  principles  of  psycho-analysis  and  re-education  which 


224 


The  Psychological  Clinic 


she  has  used  successfully  through  many  years  of  constant 
practice  and  which  she  demonstrated  in  our  clinic  at  the 
University. 

From  the  above  outline  it  will  be  seen  that  our  problem, 
while  it  includes  the  pathological  conditions  of 'mind  and 
body  which  may  be  found  to  be  of  mental  origin,  bears 
primarily,  not  upon  these  conditions,  but  upon  the  whole 
range  of  personal  adjustments  which  is  taken  into  account 
by  all  educational  effort.  The  view  of  education  as  adjust- 
ment is  not  new,  whether  one  considers  either  the  intellectual 
or  the  moral  aim.  And  while  our  work  has  an  important 
direct  bearing  upon  intellectual  success,  it  is  not  primarily 
directed  at  the  training  of  the  intellectual  life  as  this  is 
commonly  attempted  by  our  educational  disciplinary  pro- 
grams. We  are  attempting  to  deal  as  directly  as  we  may 
with  the  emotional  and  volitional  aspects  of  mental  life. 
The  major  efforts  in  this  direction  have  been  confined,  for 
the  most  part,  in  our  educational  procedure,  to  the  presenta- 
tion of  religious,  moral  and  intellectual  ideals  in  the  hope 
that  these  would  get  themselves  built  into  individual  char- 
acter. But  it  is  one  of  the  most  familiar  facts  that  minds 
may  be  supplied  with  rich  stores  of  experience  and  trained 
to  the  finest  cutting  edge  of  logical  keenness,  and  yet  out  of 
these  stores  of  experience  the  intellectual  processes  use 
material  that  is  built  into  either  partially  or  wholly  destruc- 
tive programs  of  conduct.  The  failure  is  not  due  to  faulty 
functioning  inform  of  the  well-trained  intellectual  processes, 
nor  to  any  lack  of  constructive  ideal  material  available. 
The  failure  is  more  largely  due  to  the  readiness  of  the  intel- 
lect to  accept  false  premises,  to  its  tendency  to  be  guided 
by  a false  scale  of  values,  to  the  wrong  selection  and  use  of 
materials,  and  thus  to  the  failure  of  constructive  ideals  to 
function  in  controlling  thought  and  action. 

It  is  a matter  of  common  knowledge  that  any  deep- 
seated  emotional  bias  or  attitude  inevitably  colors  all  judg- 
ments, and  in  so  far  causes  the  individual  thus  affected  to 
fail  of  the  most  successful,  clear  thought  and  efficient  action. 
Case  after  case  might  be  cited  from  any  one’s  experience  of 
persons  who  have  gone  down  to  actual  destruction,  or  who 
have  failed  of  highest  attainment,  or  the  most  fruitful  con- 


F.  E.  Owen 


225 


tribution  to  social  and  personal  values  because  of  some  bias 
that  has  kept  them  self-centered,  or  devoid  of  the  courage 
of  their  convictions.  All  their  thinking  has  been  so  moti- 
vated by  the  emotional  attitudes  present  that  it  has  led  into 
blind  alleys  and  has  fallen  into  self-contradictions  in  the 
outcome  of  the  adjustments  secured  by  it.  These  emotional 
biases  or  attitudes  run  all  the  way  from  the  most  trivial 
and  momentary  acquired  interests  to  the  most  fundamental 
instinctive  inherited  trends  of  human  nature.  They  may 
function  consciously  or  quite  without  the  individual  who  is 
motivated  by  them  being  conscious  of  their  influence  upon 
him  to  determine  his  thought  and  action.  The  intellectual 
blindness  occasioned  by  deep-seated  biased  attitudes  is 
seen  in  the  frequent  example  of  men  at  the  head  of  great 
business  ventures,  grasping  for  power,  and  more  power,  who 
little  by  little  prepare  the  way  for  the  disastrous  labor  wars 
with  their  consequent  losses  of  material,  time,  money  and 
lives.  And  yet,  in  spite  of  this  contradictory  outcome, 
these  men  persist  again  and  again  in  their  programs  of 
destruction  until  they  are  restrained  by  tardy  legislation. 
Intellect,  the  finest  in  the  country,  is  here  the  servant  of 
greedy  passions,  and  it  brings  to  pass  failure  instead  of  suc- 
cess. 

In  the  large,  one  might  point  to  the  whole  program 
of  militaristic  “efficiency”  which  is  bringing  untold  destruc- 
tion upon  the  modern  world.  This  program  was  wrought 
out  by  the  keenest  of  minds;  minds  having  at  their  disposal 
all  the  contrary  experience  of  human  history,  all  the  high 
ideals  of  the  ages,  all  the  finest  training  that  can  be  given 
the  logical  processes  by  our  modern  educational  machinery. 
And  these  minds  conceived  cunning  plans  by  which  they 
were  confidently  hoping  to  attain  place  and  position  for 
themselves  and  their  followers.  Blinded,  misled,  and  de- 
ceived by  sources  of  motivation  that  never  yet  have  suc- 
ceeded in  moving  men  to  constructive  programs,  they  have 
their  answer  in  the  cataclysm  of  failure  and  destruction  and 
ruin  which  has  come  upon  them,  and  through  them  upon 
the  whole  world. 

Everywhere  the  principle  is  the  same.  With  the  poor 
or  with  the  prosperous,  with  the  weak  or  with  the  powerful, 


226  The  Psychological  Clinic 

with  the  one,  or  with  the  many,  the  ideas  that  arise  and  the 
use  that  is  made  of  them  are  but  the  end  result  of  processes 
lying  back  in  the  emotional  life. 

Control  of  the  emotional  life  is  thus  seen  to  be  funda- 
mental to  the  constructive  functioning  of  the  intellectual 
processes.  Constant  demonstration  was  given  in  our  clinic 
of  specific,  direct,  and  effective  methods  of  discovery  and 
control  of  the  emotional  life  upon  which  hinges  volitional 
control.  With  the  changing,  by  the  methods  of  re-educa- 
tion, of  the  emotional  biases  or  trends' there  resulted  ade- 
quate and  constructive  volition,  the  tendency  to  be  in- 
fluenced by  false  scales  of  value  disappeared,  and  the  valid 
ideals,  hitherto  merely  intellectually  assented  to  became 
dynamic  realities  in  guiding  the  adjustment  program.  An 
individual  thus  rid  of  emotional  blocking  and  re-educated 
at  the  foundations  of  motivation  meets  his  life’s  problems 
with  ever  growing  efficiency  because  of  the  fact  that  his 
higher  perceptions,  his  insight  and  understanding  are  no 
longer  under  the  domination  of  blind  emotional  tendencies. 
Thus  one  great  source  of  inefficiency  and  waste  is  discovered 
and  removed. 

• But  there  is  another  fundamental  way  in  which  the 
emotional  life  is  frequently  a source  of  waste.  Attention 
has  been  called  above  to  the  fact  that  much  of  our  energy 
goes  into  “lost  motion,”  is  wasted  in  strains  and  tensions  and 
frictions.  Again  an  appeal  to  our  common  experience 
shows  us  how  intense  emotions  of  any  kind  consume  energy 
and  leave  men  and  women  exhausted  and  depleted  from  the 
loss.  Attention  from  many  quarters  has  been  called  to  the 
ennervating  effects  of  anxiety,  worry,  fear,  and  “nervous 
tension,”  and  there  has  been  much  exhortation  tc  cease 
from  these  injurious  emotional  attitudes  and  to  lead  the 
“simple  life.”  Here  again  the  attempts  at  correction  have 
been  vague  and  indirect. 

But  while  attention  has  been  often  directed  to  these 
grosser  and  more  evident  forms  of  emotional  waste — a waste 
that  weakens  the  physical  powers  and  dulls  the  capacity  for 
clear  and  constructive  thinking — there  is  need  of  knowledge 
of  the  fact  that  there  are  constantly  present  less  evident 
emotional  conditions,  both  conscious  and  unconscious,  that 


F.  E.  Owen 


227 


waste  the  energies  and  rob  the  individual  of  his  ability  to  see 
his  problems  clearly  and  form  adequate  programs  for  their 
solution.  These  emotional  attitudes  are  technically  known 
in  more  recent  psychological  literature  as  “complexes.” 

It  is  a commonly  noted  fact  that  men  and  women  in 
every  station  in  life  are  prone  to  map  out  programs  for  the 
conduct  of  their  affairs  that  lead  to  the  restriction  of  success, 
and  oftentimes  to  actual  failure,  due  to  the  conscious  or 
unconscious  fear  of  losing  their  positions.  The  constant 
evasion  of  moral  responsibility,  as  well  as  the  short-sighted 
business  plans  resulting  from  economic  fear,  are  too  evident 
on  all  sides  to  need  further  comment,  while  on  every  hand 
men  and  women  are  working  at  lowered  efficiency  and  are 
meeting  with  disappointment  of  their  hopes  and  desires, 
many  actually  breaking  down  in  health  under  these  emo- 
tional strains  and  stresses  that  are  slowly  sapping  away  their 
mental  and  physical  strength. 

It  is  a common-place  of  modern  psychological  knowledge 
that  all  reactions  to  incoming  stimuli,  all  responses  to  situa- 
tions, are  determined  either  by  the  original  nature  of  man 
(reflexes,  instincts,  and  capacities),  or  by  that  original 
nature  as  it  has  been  modified  by  experience.  It  is  further 
accepted  that  this  inner  life  of  ours  is  impulsive  in  nature 
and  seeks  satisfaction  along  the  line  of  some  form  of  expres- 
sion, and  that  those  forms  of  expression  that  bring  satisfac- 
tion tend  to  be  repeated  and  to  form  permanent  pathways 
of  response.  Response  is  along  the  line  of  the  “satisfyers” 
and  hence  we  may  say  that  all  activity  is  emotionally  moti- 
vated, a seeking  for  the  satisfaction  of  the  emotional  life. 

It  is  further  accepted  that  this  inner  mass  or  complex 
of  ideational  and  emotional  life  may  function  both  con- 
sciously and  unconsciously  in  its  determination  of  the  nature 
of  the  reactions  to  the  outer  situation,  and  that  in  the  deter- 
mination of  the  reactions  the  greater  influence  is  exerted 
by  factors  lying  outside  of  consciousness.  Very  frequently,., 
what  appear  to  be  the  conscious  factors  bringing  about 
response  are  but  rationalizations  of  the  unconscious  factors. 

These  attitudes  and  tendencies  constituting  the  in- 
dividual character  have  long  been  looked  upon  as  more  than 
relatively  fixed.  The  changing  of  even  lesser  and  more.- 


228 


The  Psychological  Clinic 


superficial  habits  is  notably  a difficult  and  relatively  unusual 
thing,  while  the  changing  or  uprooting  of  the  deeper-lying 
attitudes  that  are  foundational  to  the  personality’s  modes 
of  response  is  regarded  in  much  psychological  literature  as 
next  to  impossible,  accomplished,  if  at  all,  only  by  some 
sort  of  emotional  upheaval  such  as  sudden  conversion,  or 
some  other  profound  emotional  disturbance  either  sudden 
or  long  continued,  or  else  by  patient  and  frequently  painful 
experience  and  educative  effort  extending  over  a long  period 
of  time. 

Two  things  thus  stand  out  as  eminently  fundamental. 
First,  there  is  need  of  more  efficient  and  direct  ways  of 
establishing  desirable  habits,  desirable  fundamental  atti- 
tudes, desirable  channels  of  outlet  for  the  impulses  of  life 
from  childhood  on  through  maturity.  Second,  more  efficient 
and  direct  ways  need  to  be  devised  for  the  changing  or 
nullifying  of  injurious  or  undesirable  habits  and  fundamental 
attitudes  anywhere  they  may  manifest  themselves  along  the 
advancing  years.  The  aim  of  the  clinical  demonstrations 
given  at  the  University  by  Miss  Hamilton  was  to  indicate 
the  direction  in  which  the  solution  of  these  two  problems 
may  be  found.  The  methods  used  showed  invariably  in  a 
wide  range  of  cases  that  it  is  possible  to  uncover  and  bring 
under  the  control  of  the  personal  consciousness  of  the  in- 
dividual those  deep-seated  and  underlying  influences  or 
attitudes,  those  fundamental  tendencies  that  are  at  work 
giving  habits  their  power  and  interfering  with  the  most 
satisfactory  adjustment.  Furthermore,  by  an  intensive 
process  of  re-education  it  was  shown  that  it  is  possible  to 
free  the  personality  from  the  domination  of  harmful  habits 
and  disturbing  tendencies,  and  to  furnish  adequate  and 
satisfactory  channels  of  outlet  and  expression  for  the  hither- 
to pent-up,  or  misdirected,  and  hence  unsatisfied  emotional 
nature.  The  methods  used  give  direct  and  immediate 
access  to  the  sources  of  the  mal-adjustments,  whether  these 
causes  be  conscious  or  unconscious,  and  furnish  an  oppor- 
tunity of  dealing  with  them  more  rapidly  and  effectively 
than  is  possible  through  the  existing  methods  of  general 
education. 

With  a limited  range  of  pathological  cases  only,  some 


F.  E.  Owen 


229 


notable  corrective  work  has  been  done  by  such  men  as 
Morton  Prince,  Sigmund  Freud,  and  his  disciples.  What- 
ever else  may  be  said  in  approval  or  disapproval  of  the 
Freudian  school,  its  methods  and  theories,  this  much  should 
be  frankly  recognized  by  everyone:  that  Freud  and  his 
followers  have  furnished  abundant  scientific  evidence  of  the 
pathological  effects,  physical  and  mental,  proceeding  out  of 
repressions,  perversions,  and  fixations  of  the  sex  life.  And 
while  Miss  Hamilton  has  by  no  means  neglected  this  very 
important  and  fertile  source  of  difficulty,  she  has  extended 
her  investigations  into  the  whole  range  of  the  manifestations 
of  the  emotional  life  as  it  arises  in  connection  with  any  and 
every  sort  of  human  impulse,  instinct,  capacity  or  interest. 
It  has  been  amply  demonstrated  by  her,  both  in  private 
practice  and  in  our  clinical  work,  that  repressed,  misdirected, 
or  unsatisfied  emotional  life  is  responsible  for  a wide  range  of 
disturbances  and  mal-adjustments  in  both  the  mental  and 
physical  fields,  ranging  all  the  way  from  the  most  extreme 
pathological  difficulties  to  the  finer  errors  in  adjustment 
which  are  in  no  sense  pathological,  but  which  keep  men  and 
women  from  attaining  their  best  in  the  complex  business  of 
living.  And  while  unmistakably  neurotic  conditions  are 
sometimes  present  as  contributing  causes  to  emotional 
waste,  it  is  by  no  means  possible  to  class  all  those  who  are 
failing  of  satisfactory  adjustment,  whether  the  difficulty 
has  become  pathological  or  not,  under  the  convenient  term 
“neurotic.  ” 

In  our  clinical  work  during  the  past  year  we  have  dealt 
not  only  with  various  kinds  of  pathological  cases  made 
familiar  to  the  reader  of  the  literature  of  psycho-analysis, 
but  also  with  a wider  range  of  pathological  and  semi-patho- 
logical  cases,  and  have  extended  our  methods  to  include  all 
instances  where  the  emotional  and  ideational  life  is  found 
to  be  causing  waste,  failure,  or  partial  inefficiency  in  the 
adjustment  process.  There  is  not  wanting  abundant  evi- 
dence of  the  serious  effects  of  the  repression  or  perversion 
of  the  sex  life  (using  that  term  in  its  broad  Freudian  sense), 
and  there  is  also  abundant  evidence  that  disturbances  of  a 
serious  nature  find  their  roots  in  other  primary  causes. 
Above  all,  while  the  methods  used  make  possible  the  cor- 


230 


The  Psychological  Clinic 


rection  of  those  difficulties  that  are  pathological  or  bordering 
on  the  pathological,  and  this  is  a necessary  and  important 
phase  of  the  work,  it  should  nevertheless  be  noted  that  the 
most  significant  and  important  contribution  and  application 
of  these  methods  and  principles  are  to  educational  procedure 
because  of  the  understanding  and  control  which  they  afford 
of  those  habits  and  emotional  trends  upon  whose  proper 
direction  depends  the  success  of  both  the  intellectual  and 
moral  education  of  the  normal,  healthy  individual. 

In  the  analysis  which  is  undertaken,  while  use  is  made 
of  the  “free  association”  method,  no  use  is  made  of  hypnosis, 
dream  interpretation,  or  of  the  Freudian  system  of  symbols. 
Psycho-analysis,  as  the  term  is  generally  used  and  under- 
stood, refers  to  the  Freudian  methods  or  to  some  variation 
of  them.  But  the  term  should  not  be  thus  limited,  for  any 
procedure  by  which  the  conscious  and  unconscious  life  are 
brought  into  clear  light  for  examination  and  understanding 
may  rightly  be  called  psycho-analytic. 

The  self  is  a complex  bundle  of  inborn  tendencies  seek- 
ing satisfactory  outlet  or  expression.  As  might  be  expected 
from  a priori  considerations,  mal-adjustments  may  come 
about  from  the  misdirection  or  repression  of  this  emotional 
life  anywhere  along  the  years  from  childhood  through  ma- 
turity. It  is  the  misdirection  or  repression  of  the  emotional 
life  that  is  the  primary  cause  of  more  manifold  forms  of 
human  illness,  wastage,  and  failure  of  full  achievement  than 
has  as  yet  been  properly  recognized  and  effectively  dealt 
with.  The  clinical  work  done  at  the  University  was  for  the 
purpose  of  demonstrating  this  fact,  and  to  give  hope  that 
these  conditions  may  be  more  directly  and  efficiently  cor- 
rected than  has  heretofore  been  possible  through  existing 
educational  methods.  The  methods  that  reveal  the  causes 
may  properly  be  called  psycho-analytic,  while  the  methods 
by  which  these  causes  are  corrected  are  primarily  a matter 
of  the  re-education  of  the  emotional  and  volitional  life  at 
the  sources  of  motivation. 

We  plan  to  publish  as  rapidly  as  possible  reports  of 
cases  to  make  clear  the  position  that  in  instances  of  faulty 
adjustment  and  waste  growing  out  of  the  mental  life  the 
causes  can  be  discovered  and  removed.  It  will  be  possible 


F.  E.  Owen 


231 


in  detailing  the  cases  to  make  clearer  the  nature  of  the 
technique  of  analysis  used  in  the  discovery  of  fundamental 
causes,  and  to  present  the  methods  of  re-education  whereby 
the  individual  learns  the  control  of  the  fundamental  ten- 
dencies of  his  own  nature,  so  that  the  repressions,  the  inhibi- 
tions, the  tensions,  are  removed,  satisfying  channels  of 
outlet  discovered,  and  the  life  brought  to  its  normal  level  of 
efficient  expression.  It  will  ultimately  appear  from  our 
studies  that  the  fundamental  task  of  psycho-analysis  and 
re-education  is  that  of  bringing  to  pass  a harmonious  unity 
of  all  the  various  interests  represented  by  the  complex  inborn 
tendencies  of  the  personality.  In  essence  this  unity  is  a 
moral  unity,  for  it  involves  the  harmonizing  of  all  the  urging 
capacities  and  powers  of  the  self  with  those  fundamental 
laws  of  life,  which,  when  obeyed,  make  for  progressive, 
constructive,  satisfying  self-realization  in  the  complex  ad- 
justment process  called  life,  a process  which  has  the  in- 
dividual and  physical  needs  at  one  end,  and  the  social  and 
spiritual  needs  at  the  other. 


INSANITY  IN  AMERICAN  PRISONS  AND  THE 
PRISON  PSYCHOSIS* 


BY  G.  W.  BROCK,  M.  D. 

Atlanta , Illinois 

THE  prophylaxis  of  insanity  among  criminals  is  that 
of  insanity  as  occurring  among  any  other  class  of 
society.  The  only  exception  that  might  be  taken 
to  this  statement  would  be  the  consideration  of  a 
psychogenetic  psychosis  occasioned  by  imprisonment,  the 
so-called  “prison  psychosis,”  which  is  rapidly  passing  from 
recognition  as  a clinical  entity. 

Insanity  may  be  in  its  incipiency,  or  rather  fully  de- 
veloped in  some  cases  at  the  time  the  crime  is  committed  and 
during  the  subsequent  trial  in  court,  but  without  a proper 
mental  examination  by  those  of  special  training  as  alienists 
and  psychologists,  the  mental  deficiency  is  frequently  over- 
looked and  commitment  made  to  a correctional  institution 
instead  of  a hospital  for  insane  or  an  institution  for  anti- 
social defectives. 

The  enormity  of  breaking  the  law  often  is . the  cloud 
enshrouding  the  individual  at  fault  which  confuses  the 
minds  of  the  judiciary  who,  in  their  efforts  to  satisfy  the 
law,  frequently  send  some  poor  wrecked  or  simple  minds 
into  an  environment  where  'they  become  a trial  and  evil  to 
their  companions  of  sound  mind  and  a grave  disciplinary 
problem  to  prison  officials.  The  assistance  of  alienists  and 
psychologists  in  sorting  out  and  classifying  these  social  mis- 
fits is  being  more  frequently  sought  in  the  courts  of  our 
larger  centers  of  population.  The  saving  to  the  state  in 
needless  litigation  to  establish  the  sanity  or  insanity  of 
criminals  on  trial  and  in  the  material  reduction  of  the 
number  of  recidivists,  should  make  this  added  court  expense 
an  insignificant  consideration.  The  proper  employment  of 

*Read  at  the  Sixth  Annual  Meeting  of  the  Alienists  and  Neurologists  of 
America,  Chicago,  111.,  July  10-11-12,  1917. 


232 


G.  W.  Brock 


233 


alienists  in  courts  is  to  obtain  an  unbiased  scientific  diagno- 
sis, and  not  the  answering  of  hypothetical  questions,  and 
should  prevent  such  a case  as  occurred  some  ten  years  ago 
when  an  eastern  state  spent  a sum  sufficient  to  pay  a staff 
of  alienists  for  a generation  in  proving  that  a single  individual 
was  insane.  After  months  of  brilliant  sally  and  retort,  and 
retorts  that  were  not  particularly  brilliant,  between  the 
prosecuting  attorney  and  a squad  of  lawyers  and  medical 
experts,  the  individual  was  adjudged  insane,  but  the  endless 
disagreement  between  the  legal  and  medical  profession  and 
between  medical  men  themselves  had  so  befogged  the  minds 
of  laymen,  that  at  least  the  greater  part  of  the  population 
considered  the  prisoner  a subject  of  persecution  instead  of 
a plain  case  of  unsound  mind,  and  the  opinions  of  alienists 
as  being  very  sensitive  to  monetary  influences. 

The  question  of  insanity  in  a criminal  court  is  no  place 
for  forensic  fireworks,  but  the  careful  mental  analysis  of  the 
prisoner,  saving  friction  in  court  and  also  in  the  state  in- 
stitution to  whichever  he  may  be  committed,  as  whatever 
that  institution  may  be  it  is  peculiarly  fitted  for  his  care 
because  he  has  been  properly  classified. 

The  Classification  of  and  Statistics  pertaining  to 
criminal  insanity  and  mental  defect  in  criminals  has  been 
worked  out  more  completely  in  some  of  the  eastern  states 
than  elsewhere,  and  this  study  has  gone  hand  in  hand  with 
high  ideals  and  efficiency  in  their  care. 

In  1915  Massachusetts,  with  a total  criminal  population 
of  6925  confined  in  prisons,  jails  and  reformatories,  trans- 
ferred 137  to,  and  returned  22  from,  the  Bridgewater  State 
Hospital  for  criminal  insane,  and  other  state  hospitals. 
In  the  reformatories  for  men  and  women  located  at  Concord 
and  Sherborn  are  657  and  738  inmates  respectively;  the 
cases  are  classified  as  competent,  deviate  and  deficient  with 
a sub-classification  of  psychopath,  drug  habitue  and  un- 
classified. By  a cross  reference  syllabus  their  grades  of 
efficiency  are  designated  as  normal,  subnormal  and  segrega- 
te. Intramural  descriptive  designations  are  as  follows: 
The  competent  are  divided  into  the  occasional  offender, 
responsible  offender  and  alcoholic,  the  deviate  into  re- 
cidivist, alcoholic  degenerate,  congenital  syphilitic,  epilep- 


234  Insanty  in  American  Prisons  and  the  Prison  Psychosis 

tic,  sex  pervert  and  insane;  and  the  deficient  into  moron, 
feebleminded  and  imbecile.  The  population  of  these  two 
institutions  number  1395,  of  which  34%  are  reported  as 
competent,  23%  deviate,  25%  deficient  and  16%  include  the 
psychopath  drug  habitue  and  unclassified.  As  to  efficiency, 
42%  are  normal,  3 7%  subnormal  and  21%  segregable. 

The  number  of  recidivists  and  former  commitments  in 
Massachusetts  for  the  year  ending  1915  was  as  follows:  of 
26487  sentenced  prisoners,  5 7%  plus  or  15184  were  re- 
cidivists representing  96023  former  commitments,  making 
an  average  of  6.323  commitments  for  each  recidivist.  I 
have  given  these  statistics  concerning  criminology  in  Massa- 
chusetts, at  such  length  because  they  should  be  a model 
for  many  other  states.  Massachusetts  is  asking  for  better 
segregation  of  its  criminal  population  and  a more  satisfactory 
indeterminate  sentence. 

In  the  four  state  prisons  of  New  York  with  5284  inmates 
only  45  insane  were  transferred  to  the  state  hospitals  for  the 
criminal  insane  during  1915.  The  two  state  hospitals  for 
criminal  insane,  Alatteawan  and  Dannemora,  had  a total 
admission  of  225  which  also  included  commitments  from 
jails,  reformatories  and  the  original  courts  of  jurisdiction. 

Dannemora,  which  receives  men  only,  returns  all  re- 
covered cases  to  Clinton  prison,  the  two  institutions  being 
adjacent,  there  to  serve  out  their  unexpired  time  regardless 
of  where  formerly  confined.  This  plan  has  the  further 
advantage  that  if  there  is  a mental  relapse  they  are  again 
returned  to  Dannemora,  thereby  avoiding  delay  in  treatment 
and  long  transfers  at  added  expense  to  the  state  and  danger 
of  escape.  The  population  numbers  517  and  on  account  of 
over  crowding  this  hospital  receives  only  acute  cases  with 
the  exception  of  those  relapsing  in  Clinton  Prison.  The 
predominence  of  paranoid  forms  of  dementia  precox  and 
cases  of  constitutional  inferiority  with  paranoid  trend  make 
up  over  half  the  admissions.  These  percentages,  I believe, 
generally  hold  good  throughout  the  country.  General 
paresis  is  rare  in  this  hospital,  the  average  number  of  annual 
admissions  since  its  founding  in  1900  being  1.6. 

Matteawan  draws  from  the  Metropolitan  district  and 
with  a population  of  856  is  greatly  overcrowded.  The 


G.  W.  Brock 


235 


superintendent  in  his  annual  report  says,  “this  overcrowding 
could  be  somewhat  ameliorated  if  a large  number  of  mis- 
demeanants were  committed  to  civil  hospitals  or  make  such 
transfer  mandatory  as  soon  as  the  term  of  imprisonment 
has  expired.  A psychiatric  clinic  in  connection  with  the 
lower  courts  in  Greater  New  York  would  prevent  the  sen- 
tencing of  advanced  cases  of  dementia  paralytica,  senile 
dements  and  well  defined  dementia  precox  to  penal  in- 
stitutions for  vagrancy,  disorderly  conduct  and  similar 
crimes.”  Thirty-seven  percent  of  the  admissions  in  1916 
were  committed  directly  by  the  court  of  original  jurisdiction. 

The  European  war  preventing  the  repatriation  and 
deportation  of  alien  insane  has  also  added  to  the  con- 
gestion of  these  hospitals.  The  percentage  of  admissions 
of  cases  of  dementia  paralytica  to  Matteawan  continued  to 
increase  from  2%  in  1906  to  12.5%  in  1915,  compared  with 
the  average  annual  admission  of  1.6  cases  received  at  Danne- 
mora;  the  great  difference  between  a hospital  drawing  from 
a Metropolitan  district  and  one  from  a rural,  determines 
where  syphilis  is  most  common,  or  that  in  the  city  the  hard 
driven  nervous  organism  may  be  more  susceptible  to  the 
invasion  of  the  spirochaetae.  It  is  observed  that  the  manic 
depressive  psychosis  is  rarely  met  with  as  compared  with 
civil  hospitals.  Alcoholic  psychosis  is  on  the  decrease  due 
to  restrictive  legislation  against  alcohol. 

Sixteen  states  from  which  reliable  statistics  were  ob- 
tainable had' a population  of  24,315  confined  in  their  state 
prisons;  of  these  7.2  prisoners  per  thousand  of  prison  popula- 
tion were  transferred  to  hospitals  for  the  insane  during  the 
year  ending  1915,  which  is  at  least  10%  higher  than  com- 
mitments to  insane  hospitals  from  the  civil  population. 

. During  the  five  year  period  ending  in  1902  the  ad- 
missions to  public  and  private  institutions  for  the  insane  in 
England  and  Wales  averaged  6.2  individuals  per  10,000 
population.  Such  statistics  indicate  a wide  gap  in  the 
mental  stability  of  criminals  as  compared  with  the  civil 
population,  and  I believe  that  this  mental  instability  will  be 
found  at  the  time  of  trial  or  commitment  when  proper 
examination  is  made,  in  such  a proportion  of  cases  that  the 
mental  makeup  of  the  individual  and  not  the  influence  of 


236  Insanity  in  American  Prisons  and  the  Prison  Psychosis 

imprisonment  will  render  obsolete  the  term  “prison 
psychosis.” 

Those  who  are  of  normal,  or  practically  normal  mind  as 
the  criminal  by  passion  or  the  accidental  criminal;  and  in 
past  times  the'imprisonment  of  men  for  financial,  religious  or 
political  cause,  such  as  Bunyan,  Raleigh,  Tasso,  etc.,  men 
having  a more  sensitive  mind,  and  more  to  lose  in  the  rich 
experiences  of  life,  would  be  expected  to  furnish  the  highest 
percentage  of  true  psychogenetic  alienation  due  to  im- 
prisonment, but  statistics  do  not  bear  this  out,  notwith- 
standing the  crime  of  passion  incurs  a long  sentence  and 
some  of  these  men  do  eventually  undergo  mental  deteriora- 
tion due  to  senile  decay.  It  is  the  degenerate  “door  mat” 
thief,  the  offender  of  the  weakling  class  that  fills  the  psycho- 
pathic hospitals. 

Dr.  Bowers,  in  the  American  Journal  of  Insanity  for 
July  1913,  says  “the  lower  grades  of  criminals,  incapable 
of  intense  mental  suffering,  because  of  their  low  grade 
mentalities  and  emotional  poverty,  are  the  ones  to  develope 
active  insanities  during  confinement.  The  diseases  which 
have  been  most  often  termed  the  ‘prison  psychosis’  are{ 
the  psychoses  of  degeneracy  and  hysteria.  ” 

In  January  1915,  the  warden  asked  me  as  prison 
physician,  to  select  a committee  to  make  a mental  survey  of 
the  prisoners  in  the  Illinois  State  Penitentiary  at  Joliet. 
A brief  summary  of  the  report  of  this  committee  follows: — 
Careful  individual  study  and  final  disposition  as  to 
segregation  and  employment  was  urgently  recommended 
along  the  following  outline: 

I.— The  establishment  of  a psychologic  institute  as  a de- 
partment of  the  prison.  This  institute  should  fulfill  the 
following  requirements : 

(a) - — The  director  to  be  a trained  psychologist. 

(b) - — The  physician  to  the  prison  to  be  selected  with  special 
reference  to  experience  in  nervous  and  mental  diseases, 
associating  in  the  labors  of  the  psychologist,  and  I 
would  here  add  that  I hope  the  physician  trained  in 
psychiatry  would  be  very  tolerant  in  regard  to  the 
measuring  stick  of  mental  age,  and  that  the  psy- 


G.  JV.  Brock 


237 


chologist  would  not  persist  in  calling  every  apathetic 
dumbhead  a dementia  precox. 

(c) - — Detailed  information  as  to  the  life  history  of  all 
convicts  either  by  probation  officers  or  special  field 
workers. 

(d) — A special  building  for  receiving  and  detaining  all 
convicts  on  admission  until  examined  mentally  and 
physically,  properly  classified  and  recommendations 
made  as  to  the  best  mode  of  their  employment. 

(e)  — Observation  and  re-examination  at  suitable  intervals. 

(f) - — Detailed  records  of  the  results  of  all  examinations 
with  summary  and  cross  reference  indexes. 

2. — The  provision  of  buildings  for  separate  accommodation 
of  at  least  the  main  types  which  were  classified  as 
follows : — 

(a)  — Criminals  by  accident  of  adult  intelligence  and  sub- 
normal intelligence. 

(b) — Borderline  cases. 

(c) — Anti-social  individuals  of  adult  intelligence  and  sub- 
normal intelligence,  and 

(d)  — Insane  persons. 

The  anti-social  types  to  be  kept  entirely  away  from  the 
others,  requiring  buildings  enclosed  within  a stockade. 
The  borderline  cases  under  strict  guard. 

The  accidental  types  given  more  open  conditions  and 
employed  upon  honor,  the  feeble  minded  and  some  others 
requiring  closer  supervision.  Hospital  conditions  should 
be  fully  adequate. 

The  insane  cared  for  in  a state  hospital  for  criminal 
insane  in  adjacent  grounds,  the  medical  staff  of  this 
hospital  cooperating  with  that  of  the  psychologic  in- 
stitute. 

3 —  The  extension  of  outdoor  occupations,  with  special 
efforts  to  prescribe  the  work  most  suited  to  the  education 
of  the  individual  convict. 

4 —  The  Board  of  Pardons  to  have  the  advantage  of  the 
records  and  advice  of  the  psychologic  institute  and  the 
services  of  an  adequate  number  of  prodation  officers. 

The  psychiatric  and  neurological  examinations  were 
made  by  Dr.  H.  Douglas  Singer  and  the  psychologic  tests  by 


238  Insanity  in  American  Orisons  and  the  Prison  Psychosis 

Dr.  and  Mrs.  George  Ordahl.  The  neurological  examination 
disclosed  a very  high  proportion  of  abnormalities.  Psycho- 
logically fifty  men  and  49  women  showed  an  average  mental 
age  of  1 1.2  and  11.7  respectively,  the  actual  or  chronological 
age  being  30  and  34  years. 

Illinois  transfers  its  criminal  insane  to  the  Chester 
State  Hospital,  which  has  a population  of  221  patients. 
This  hospital  is  overcrowded,  leaving  many  cases  in  the 
prisons  that  should  have  the  care  of  a hospital  for  mental 
disease.  With  cramped  quarters  and  very  poorly  equipped, 
this  institution  bears  no  resemblance  to  the  high  class  and 
efficient  hospitals  for  the  civil  insane  of  Illinois. 

I wish  also  to  mention  the  unsanitary  prison  hospital 
at  Joliet.  The  armamentarium  in  all  departments,  surgical, 
pathological  and  diagnostic  is  either  antiquated  or  lacking; 
and  the  building  would  serve  much  better  as  a cow  stable 
than  it  does  as  a hospital.  Here  insane  prisoners  are  often 
detained  for  weeks  in  the  so-called  “crank  cells”  because  of 
overcrowded  conditions  at  Chester.  Many  other  states 
must  answer  to  like  conditions. 

Massachusetts  and  New  York  have  made  an  endeavor 
to  bring  their  hospitals  for  the  criminal  insane  up  to  the 
level  of  the  other  state  hospitals,  but  outside  of  these  states 
there  is  much  to  be  done.  Indiana  has  an  institution  for  the 
criminal  insane  that  is  well  conducted  but  is  reported  as 
overcrowded.  The  last  legislature  of  the  state  of  New 
Jersey  appropriated  $5,000.00  to  investigate  by  specialists 
the  mental  status  of  all  inmates  in  the  state  prison.  Other 
states  are  taking  up  this  study  in  various  ways. 

The  states  with  a small  population  can  care  for  their 
criminal  insane  best  in  the  state  hospitals,  but  the  criminal 
insane  should  have  a special  ward  set  aside  for  them  as 
otherwise  discipline  is  harder  to  maintain  and  the  institution 
is  subject  to  complaint  from  the  relatives  of  civil  inmates. 

Those  states  having  a large  population  should  have  a 
state  hospital  for  criminal  insane,  and  it  should  be  built  on 
plans  looking  toward  increase  in  population  so  that  over- 
crowding at  least  for  a time  will  be  avoided. 

Insane  should  not  be  confined  in  prisons,  as  is  the 
custom  in  some  few  states,  as  it  is  impossible  for  them  to  be 


G W.  Brock 


239 


properly  segregated.  It  is  from  the  lack  of  classification 
and  segregation  that  the  honor  system  has  failed  in  some 
instances.  The  idea  is  good,  but  its  application  was  at- 
tempted before  some  of  our  institutions  were  ready  for  it. 

The  great  problem  in  the  care  of  convicts  is  not  the 
criminal  of  passion  or  accident,  of  normal  or  practically 
normal  mentality,  nor  the  criminal  that  has  suffered  the  loss 
of  mind  in  the  development  of  insanity,  but  the  anti-social 
defective. 

Many  of  these  criminals  with  painstaking  study  appear 
of  mental  normality  and  have  been  termed  “moral  imbecile” 
or  “moral  insanity.  ” Healy  in  his  “Individual  Delinquent” 
says,  “A  moral  imbecile  does  not  exist  in  his  experience  and 
that  these  terms  are  misleading  and  tending  to  confusion, 
such  states  always  being  accompanied  by  some  mental 
subnormality  or  aberration.”  It  is  these  borderline  cases 
that  constitute  the  acute  disciplinary  problem  in  correctional 
institutions. 

This  paper  is  offered  as  an  appeal  for  better,  for  equally 
as  good  care  for  the  criminal  insane  as  is  given  the  civil  in- 
sane in  our  best  state  hospitals. 


THE  CONDUCT  OF  THE  INSANE: 

A CONTRIBUTION  TO  PSYCHOPATHOLOGICAL 
THEORY.1 

BY  HAROLD  I.  GOSLINE,  M.  D. 

Pathologist , Worcester  State  Hospital.  Assistant  in  Neuro- 
pathology, Harvard  Medical  School. 

NATURALLY,  it  is  with  a good  deal  of  hesitation 
that  one  presents  a psychological  subject  before  a 
meeting  of  neuropathologists.  If  my  subject  may 
be  considered  more  strictly  a psychopathological 
one,  perhaps  there  is  some  superficial  resemblance.  Psycho 
and  neuro — we  need  make  only  one  fundamental  presupposi- 
tion and  that  has  been  made  for  us  long  ago.  Medical  men 
long  ago  have  supposed  that  the  brain  and  the  mind  were 
inseparable.  They  will  have  nothing  to  do  with  a tran- 
scendental, mystical  psyche.  But  without  any  reference 
to  affairs  which  may  be  considered  superficial  and  academic 
we  will  attempt  in  the  few  moments  which  are  our  portion, 
to  introduce  a new  idea  into  neuropathology;  realizing  that 
the  introduction  of  a concept  is  often  a matter  of  years 
rather  than  of  moments. 

Men  are  wont  to  think  of  psychology  as  something  too 
unreal,  too  intangible;  practical  men,  I might  almost  say, 
have  given  it  up  for  something  more  profitable.  Psychia- 
trists in  general,  as  practical  men,  will  deny  that  psychology 
has  much  of  service  to  offer  them — many  will  doubtless 
claim  that  psychopathology  is  but  a scape-goat  brother  and 
possibly  it  has  been  made  so  in  some  instances. 

In  charge  of  legally  committed  cases,  the  psychiatrist 
is  the  creation  of  economic  and  social  conditions— the  im- 
possibility of  caring  for  the  insane  by  any  other  means  than 
that  of  the  public  funds  and  the  impossibility  of  depriving 

1A  contribution  to  the  William  Leonard  Worcester  Memorial  Series  of  Danver 
State  Hospital  Papers,  presented  Nov.  19,  1915. 

240 


Harold  I.  Gosline 


241 


an  individual  of  his  liberty  without  legal  process.  The 
psychiatrist  has  to  satisfy  the  law  with  regard  to  the  pa- 
tient’s insanity.  He  has  to  satisfy  the  friends  of  the  patient 
as  to  the  necessity  of  further  residence  or  as  to  the  ad- 
visability of  discharge,  in  addition  to  being  prepared  for  all 
those  other  contingencies  of  illness  and  accident  which  the 
average  internist  must  meet. 

From  the  records  which  have  arisen  as  a result  of  these 
external  forces,  has  come  a mass  of  data  useful  for  classifica- 
tion or  diagnosis  and  for  prognosis.  The  psychiatrist  is 
quite  justified  in  his  refusal  to  be  interested  in  the  fields  of 
psychology  and  psychopathology,  so  unpractical  to  him. 
But  we  would  offer  it  here  as  a proposition  which  is  not  en- 
tirely new,  that  the  true  position  of  the  mental  internist, 
speaking  from  one  point  of  view  and  the  position  in  which 
he  might  hope  for  the  greatest  progress  in  the  knowledge  of 
mental  disease,  is  as  the  psychopathologist. 

This  transfer  of  the  psychiatrist  into  the  psycho- 
pathologist occurs  whenever  the  mental  internist  uses  disease 
concepts  divorced  from  legal  and  popular  concepts,  for  the 
purpose  of  exact  scientific  thinking.  It  is  this  phase  of  the 
work  of  the  psychiatrist  which  is  of  interest  and  of  value  to 
the  neuropathologist  and  it  might  even  be  said  is  the  neces- 
sary factor  in  bringing  to  a successful  issue  the  efforts  of  the 
latter  at  correlation. 

This  is  the  new  idea  and  one  which  may  appear  pedantic. 
But  has  it  never  occurred  to  anyone  that  as  psychiatrists  we 
are  possibly  not  studying  abnormal  variations  alone,  but 
something  more  than  that? — trying  to  adjust  the  patient  to 
his  environment.  The  more  case-histories  one  studies  the 
more  does  one  become  convinced  that  such  is  the  truth.  It 
becomes  apparent  that  there  is  no  definite  psychopathological 
language  but  something  more — a psychiatric  language. 

The  attempt  to  build  a psychopathological  vocabulary 
is  the  attempt  to  form  a branch  of  physiology.  If  behavior 
is  a function  of  nervous  tissue,  and  we  must  suppose  that  it 
is,  then  it  is  apparent  that  any  variation  in  behavior  must  be 
conditioned  by  changes  in  the  nervous  tissue.  The  forma- 
tion of  descriptive  terms  to  stand  for  these  variations  is  the 
formation  of  a branch  of  physiology,  or  of  pathological 


242 


The  Conduct  of  the  Insane 


physiology  if  such  a contradiction  in  terms  may  be  permitted. 
It  is  needless  to  say  that  the  formation  of  such  a language  is 
not  attempted  in  this  paper — but  it  may  be  said  that  an 
attempt  will  be  made  to  point  out  one  or  two  of  the  possi- 
bilities, and  it  is  hoped  that  some  hint  may  be  given  of  the 
fundamental  value  of  such  studies  for  the  localization  of 
function. 

A study  was  made  of  approximately  250  cases  resident 
at  the  Middleton  Colony.  Their  behavior  at  the  present 
time  was  summarized  from  the  ward  reports  of  the  nurses  in 
charge.  The  behavior  of  the  same  patients  at  admission  was 
summarized  from  the  card  catalogue  for  such  symptoms. 
(At  this  point  I would  say  that  I can  not  praise  too  highly 
the  wise  foresight  of  our  Superintendent,  in  continuing  this 
card  index.  The  system  might  be  extended  to  other  Hospi- 
tals with  advantage).  If  we  had  gone  no  farther  our  search 
would  be  rewarded.  It  was  found  that  the  words  used  by 
both  doctors  and  nurses  fell  quite  naturally  into  two  main 
groups — the  group  of  the  strong  and  that  of  the  weak.  This 
distinction  between  words  has  long  been  made  by  rhetoricians 
but  the  practical  bearing  of  the  distinction  is  not  so  apparent 
until  we  realize  that  words  may  be  made  to  exactly  express 
the  condition  of  our  patients.  But  this  was  not  all  that  be- 
came evident  by  our  simple  comparison  of  the  terms  used  at 
admission  and  at  the  present  time.  The  words  used  at  both 
times,  that  is  by  both  doctors  and  nurses,  were  almost  with- 
out exception  those  of  purely  objective  description.  A ords 
coined  by  nurses  were  purely  of  objective  description, — 
some  contain  a personal  element — while  those  coined  by- 
physicians  frequently  contain  a deal  of  interpretation. 

Of  the  terms  used  at  admission  some  have  been  dropped 
almost  entirely  at  the  present  day.  Bulimia  has  been  replaced 
by  abnormal  appetite,  sicchasia  and  sitiophobia  by  refusal  of  food; 
these  have  also  been  called  mental  anorexia.1  The  point  is, 
patients  do  not  eat — to  say  that  they  abhor  food  (sitiophobia) 
is  perhaps  saying  too  much;  it  is  at  least  combining  an  interpreta- 
tion in  an  observation — it  is  making  a diagnosis  in  stating  a symp- 
tom. Disgust  for  food  (sicchasia)  is  no  better,  of  course,  and  re- 
fusal of  food,  the  ordinary  term  of  today  introduces  an  element 
of  will  into  the  patient’s  reaction  which  is  not  known  to  exist  there. 


Haroid  I.  Gosline 


243 


Abulia  has  merely  been  replaced  by  its  synonym — loss  or 
defect  of  will  and  is  commonly  used  as  a point  in  diagnosis.  The 
motor  phenomena  which  give  rise  to  this  term  are  equally  well 
described  by  loss  or  defect  of  attention  which  has  the  added  ad- 
vantage of  reducing  said  motor  phenomena  to  something  tangible 
which  can  be  observed  by  the  method  of  introspection  and  re- 
solved into  elements  which  are  kinesthetic  in  origin.  No  one  will 
deny  that  it  is  motor  phenomena  which  have  given  rise  to  the 
confusion  in  terms  here  pointed  out  and  psychopathology  will 
render  a service  to  neuropathology  in  insisting  on  this  point  and 
that  search  be  made  first  in  the  motor  regions  or  on  the  other  side 
of  the  reflex  mechanism,  in  the  kinesthetic  regions.  In  making 
his  searches  in  these  regions  the  neuropathologist  should  bear  in 
mind  Bastian’s  ideas  of  the  distribution  of  the  motor  and  kines- 
thetic areas.2 

Certain  other  terms  seem  to  have  been  used  with  a sense  of 
doubt  on  the  part  of  the  observers.  On  the  other  hand  terms  have 
been  used  with  the  greatest  confidence  as  to  their  significance  but 
with  no  fundamental  understanding  of  their  meaning  and  no  uni- 
form method  of  application.  In  this  connection  I will  never  forget 
a personal  experience  in  trying  to  define  “psychomotor  excitement.’’ 

The  terms  used  now  are  those  used  by  nurses  on  the  wards. 
They  represent  what  may  be  called  the  first  degree  of  observation 
since  they  are  devoid,  necessarily  for  the  most  part,  of  all  inter- 
pretation. The  word  “confused”  used  once  by  a nurse,  was  the 
only  departure  from  the  rule.  They  approach  more  nearly  the 
ideal  of  a pure  objective  description — are  nearer  being  a descrip- 
tion of  conduct  and  hence  are  more  adaptable  for  clinico-pathologi- 
cal  correlations.  Naturally,  it  is  unnecessary  to  adopt  all  the 
naivite  (spits,  drools,  shouts,  sings')  of  the  descriptions  at  times 
produced  just  as  it  is  necessary  to  eliminate  the  element  of  personal 
feeling  (abusive,  disagreeable,  dull,  etc.) 

The  terms  used  both  at  entrance  (by  physicians)  and  now 
(by  nurses)  are,  with  single  exceptions  to  be  named  later,  those 
of  the  first  order  of  observation,  that  is  to  say,  terms  of  objective 
value  without  interpretation.  They  are  the  most  stable  and  carry 
the  picture  well.  They  are  denudative,  destructive,  excited, 
irritable,  manneristic,  masturbating,  self-mutilating,  negati  . istic, 
noisy,  obscene,  profane,  resistive,  untidy,  violent,  vomiting,  in- 
coherent. Strangely  enough  the  term  “incoherent”  seems  cor- 
rectly applied  by  all  in  spite  of  the  fact  that  many  observers  could 
not  define  its  opposite  or  far  less  enumerate  the  factors  necessary 
to  the  attainment  of  its  opposite. 

The  few  terms  of  interpretation  used  both  at  admissions  and 
now  are  depressed,  drowsy,  stupid,  all  of  which  apply  to  reactbns 
characterized  by  little  motor  display. 

Delusions  and  hallucinations  can  never  be  objective,  since. 


241 


The  Conduct  of  the  Insane 


their  determination  depends  on  the  patient’s  statement  though 
they  may  be  taken  practically  to  be  so. 

There  are  certain  terms  of  the  first  degree  of  observation  which 
are  probably  unknown  to  our  nurses,  which  would  account  for 
their  non-appearance  now.  They  are  “euphoria”  and  “ex- 
pansiveness” shown  in  the  patient’s  speech  productions,  and 
“elation”  and  “exaltation”  shown  in  the  motor  activities  ex- 
pressed in  manner,  dress,  etc.,  in  addition  to  the  speech. 

That  a correlation  between  clinical  symptoms  and  brain 
findings  which  is  fairly  direct  does  exist  here  has  recently  been 
pointed  out.3  I have  purposely  modified  the  statement  by  the 
words  “fairly  direct”  for  the  reason  that  the  correlation  is  not  so 
much  between  the  words  “euphoria”  etc.,  and  the  brain  condi- 
tion, as  it  is  between  the  lack  of  contact  with  the  outer  world  of 
conditions,  and  the  physical  state  of  the  brain.  As  pointed  out 
in  that  remarkable  paper  referred  to,  the  patient  talks  of  millions 
when  he  is  penniless,  he  is  an  athlete  when  it  is  apparent  that  he 
can  not  move  because  of  general  paresis  of  all  the  movements,  in 
other  words  he  is  entirely  out  of  touch  with  the  reality  and  to  cor- 
respond we  have  the  expected,  that  the  brains  of  paretics  with  such 
a clinical  picture  show  the  grossest  and  most  extensive  lesions. 

It  is  apparent  then  that  in  this  case  we  must  go  beneath  the 
words  and  actions  of  the  patient  in  making  our  correlations.  If 
this  finding  in  paresis — the  divorce  of  the  patient  from  contact 
with  the  real — is  found  to  be  of  more  general  application,  we  have 
at  least  one  practical,  tangible  direction  of  research  disco',  ered 
already  for  psychopathology,  that  is  to  say,  the  comparison  of  the 
phantasies  of  the  patient  with  his  actual  condition,  taking  the 
discrepancy  as  an  index  of  the  amount  of  damage  done  to  his 
brain.* 

A comparison  of  patients  in  this  series  where  nothing  more 
was  possible  than  the  comparison  of  their  present  condition  with 
their  condition  at  admission,  showed  that  of  those  with  elated, 
expansive,  exalted,  and  euphoric  tendencies  (41  cases)  12%  now 
show  no  reaction,  while  the  remainder  show  a weakened  reaction. 

Disturbances  of  memory  occur  with  fair  frequency.  They 
are  exceeded  only  by  the  various  forms  of  disorientation,  delusions 
and  hallucinations  and  occur  in  76  of  the  251  cases.  The  field  of 
the  amnesias  has  been  but  little  worked  and  that  only  in  con- 
nection with  the  aphasias.  It  has  been  found  that  there  is  a 
memory  for  words  as  they  are  heard  and  as  they  are  seen  together 
with  a memory  of  the  kinesthetic  impressions  aroused  in  the 

*This  lack  of  correspondence  between  the  ideas  of  the  patient,  as  expressed  in 
his  talk  and  his  real  condition  has  been  considered  by  some  workers  as  a pheno- 
menon, explainable  on  psychological  grounds.4  If  the  phenomenon  is  explainable 
in  this  way,  it  may  be  fitting  to  ask  why  of  the  41  cases  in  this  series  not  one  showed 
the  same  symptoms  after  a period  of  4-57  years,  but  all  had  arrived  at  a state  of 
mild  excitement  characterized  by  irritability,  restlessness  and  noisiness? 


Harold  I.  Gosline 


245 


pronunciation  of  words.  These  have  been  fairly  narrowly 
localized.  5 6 7 But  in  the  case  of  the  frank  psychoses  we  make  no 
note  for  the  most  part  as  to  the  definite  memory  involved — we 
merely  write  “partial”  or  “complete  amnesia.” 

The  duration  of  the  psychosis  was  from  about  I year 
(one  case)  to  67  years  (one  case),  the  psychiatric  diagnoses 
Dementia  Praecox  and  allied  (138  cases),  Manic  Depressive 
and  allied  (18  cases),  Senile  and  allied  (45  cases),  General 
Paralysis  and  allied  (7  cases),  Alcoholic  psychoses  (14  cases), 
Imbeciles  and  allied  (22  cases),  Epileptic  Dementia  (1  case), 
Huntington’s  Chorea  (1  case),  Hysteria  (2  cases),  Unclassi- 
fied (3  cases).  The  symptoms  which  form  the  basis  for  this 
study  were  selected  and  studied  without  regard  to  psychiatric 
diagnosis.  The  relation  of  the  present  condition  of  the 
patient  to  the  duration  of  the  disease  showed  that  there  was 
a tendency  to  a type  reaction  of  a weak  sort  whether  the 
disease  ran  16,  17,  19,  or  37  years,  when  studied  specifically 
for  those  who  were  destructive  at  admission.  This  finding 
was  general  for  the  duration  of  psychosis,  though  not  for 
every  symptom. 

This  comparison  affords  us  an  example  not  unlike  those 
appearing  in  general  systemic  and  infectious  diseases  where 
the  duration  of  the  disease  may  have  little  to  do  with  the 
ultimate  result,  though  the  result  may  be  more  or  less 
similar  over  a series  of  cases. 

Twelve  who  were  destructive  at  the  beginning  of  the  psychosis 
were  compared.  Three  had  run  a course  of  16  years  and  were 
irritable  and  excited;  two  were  noisy;  one  violent;  one  talkative; 
profane,  restless  and  aggressive;  one  untidy,  depressed,  negativistic 
and  masturbated.  Of  two  cases  with  a course  of  17  years,  one 
conformed  to  routine — that  is  to  say,  there  was  no  report;  one 
showed  a weak  reaction,  was  excited,  noisy,  resistive,  profane, 
irritable,  talkative,  restless  and  untidy.  Three  had  a course  of 
19  years — all  are  aggressive;  two  violent;  all  for  the  most  part  are 
in  the  weakly  reacting  class.  Two  had  a course  of  30  years — one 
is  destructive,  (had  a shock  recently);  both  have  a weak  reaction. 
Two  had  a course  of  37  years — one  now  has  no  reaction;  one  a 
strong  to  weak  reaction,  is  aggressive  and  violent  but  also  noisy, 
irritable,  talkative,  and  restless. 

More  exact  and  perhaps  more  interesting  would  be  a com- 
parison of  patients  of  the  same  age,  with  the  same  symptoms  at 
the  beginning  and  the  same  duration  without  known  heredity  or 
with  similar  heredity  as  far  as  such  is  possible. 


246 


The  Conduct  of  the  Insane 


The  condition  of  the  patients  as  shown  by  individual 
symptoms  was  next  found  to  differ  now  from  their  condition 
at  admission. 

Of  20  cases  which  are  now  destructive — duration  31 
years — one  was  depressed,  apathetic,  indifferent,  hallu- 
cinated at  admission;  one  jealous,  violent  and  restless. 
Opposite  or  dissimilar  conditions  at  entrance  may  show  the 
same  condition  in  time. 

A comparison  of  the  present  state  of  patients  showing 
dissimilar  states  at  admission  shows  that  the  active  patients 
are  now  rather  the  less  active  ones — a result  not  exactly  to 
be  expected  from  the  picture  at  admission. 

Comparing  those  who  were  confused  with  those  who 
were  destructive,  we  find  that  the  present  state  is  similar, 
that  is,  a weak  reaction  exists,  but  in  the  latter  there  is  a 
higher  percentage  showing  drowsiness,  stupidity,  and  un- 
tidiness now — not  corresponding  with  the  duration  of  the 
disease  and  the  age  of  the  patient — while  the  percentage 
showing  no  reaction  or  the  reaction  of  conformation  is  the 
same  in  each,  25%.  (The  cases  are  different).  We  have  a 
weak  reaction  (pale,  colorless  words)  as  the  general  tone  in 
spite  of  occasional  more  active  demonstrations  and  there  is 
a tendency  to  signs  of  deterioration  shown  more  in  those 
who  were  destructive  at  the  start.  What  little  we  know  in 
general  of  confusion  and  destructiveness  might  have  led  us 
to  expect  quite  a different  outcome,  since  in  general  people 
who  are  confused  are  commonly  thought  to  be  “worse  off” 
individually  than  those  who  are  destructive,  though  perhaps 
the  latter  are  more  dangerous  to  the  community. 

Frequently  the  symptoms  at  admission  are  found  to  be 
absent  now.  We  seldom  find  the  symptom  of  admission 
carried  down  to  the  present. 

Of  29  cases  which  were  destructive  at  admission  only  3 are 
destructive  now;  of  72  cases  which  were  irritable  at  admission 
only  30  are  now  irritable  although  there  are  now  126  cases  showing 
irritability.  Of  24  cases  showing  mannerisms  at  admission  only 
one  is  still  manneristic.  Of  12  cases  of  negativism  only  one  is  now 
negativisti'c;  41  others  have  developed  this  symptom,  making  a 
total  of  42  who  now  show  it.  There  were  22  cases  obscene  at 
admission — none  of  them  are  now  obscene.  Only  3 cases  were 
profane — I is  still  profane  and  there  are  47  others  who  are  now 


Harold  I.  Gosline 


247 


profane.  Forty-four  were  resistive  at  admission;  of  these,  9 are 
now  resistive.  There  are  61  resistive  patients  now,  making  52 
new  cases  which  have  developed  the  symptom  and  35  patients 
from  whom  it  has  disappeared.  Fifty-nine  cases  were  restless  at 
admission;  32  are  restless  now,  while  11  have  completed  deteri- 
orated. At  present  121  patients  are  restless  making  16  of  the 
original  59  cases  which  are  not  restless  though  they  are  still  reacting 
and  89  who  have  become  restless  since  admission  and  are  now  rest- 
less. Of  9 cases  untidy  at  admission,  1 ' is  untidy  now  while  36 
others  have  become  so  and  this  is  not  related-  to  their  age  in  many 
cases.  Of  64  violent  cases  at  admission  7 are  still  violent  at  times- — 
57  cases  have  ceased  to  be  violent  and  of  the  57  cases,  11  do  not 
react  at  all.  Thirty  cases  are  now  violent  making  23  new  cases  to 
become  violent  since  admission.  (See  table  I). 

From  the  above  data  we  may  rightly  draw  the  following 
conclusions;  that  there  is  a tendency  to  an  increase  in 
irritability,  negativism,  profanity,  resistiveness,  untidiness 
and  the  state  of  absolute  subjection  to  routine  while  violence 
decreases  and  obscenity  dies  out.  Resistiveness  shows  a 
smaller  increase  than  irritability.  Restlessness  and  irri- 
tability persist  from  admission  to  the  present  time  in  more 
cases  than  any  other  symptoms. 

Let  us  rest  content  to  state  the  facts  without  theorizing 
as  to  causes.  But  if  words  may  be  taken  as  an  accurate 
representation  of  the  condition  of  our  patients,  these  words 
show  that  there  is  a change  in  our  patients — and  all  these 
words  are  objective  with  the  exception  of  “depressed” 
which  is  at  times  used  improperly.* 

No  one  may  doubt  that  words  can  accurately  represent  the 
condition  of  our  patients  but  it  is  another  phase  of  thought  which 
wills  to  present  this  fact  acutely  and  objectively.  It  is  certainly 
unjustifiable  to  rest  forever  content  with  impressions  merely. 

We  next  studied  the  frequency  of  occurrence  of  what 
may  be  considered  the  major  symptoms  at  entrance.  While 
not  purely  objective,  except  in  a few  instances,  these  terms 
do  not  carry  interpretation  and  are  applied  by  means  of 
fairly  objective  tests.  It  was  found  that  amnesia  and  dis- 

*A  patient  was  admitted  to  this  Hospital  on  a certificate  which  stated  that  the 
patient  had  become  depressed  for  no  apparent  reason  and  had  refused  to  speak  for 
two  weeks.  (Note  the  “will”  element  in  “refused  to  speak”).  She  was  found  to 
be  aphasic  and  hemiplegic  with  a positive  blood  and  spinal  fluid.  Later  she  re- 
covered her  speech  and  the  use  of  her  limbs  to  a moderate  degree.  An  objective 
statement  would  have  been  accurate.  An  “interpretative”  statement  was  in  this 
case  proven  to  be  entirely  erroneous. 


248 


The  Conduct  of  the  Insane 


orientation  occur  with  almost  equal  frequency,  while  appre- 
hensiveness and  indifference  occur  with  equal  frequency  al- 
though they  occur  about  half  as  often  as  the  first  two  symp- 
toms. Insomnia,  seclusiveness,  and  suicide  go  together,  as 
do  muteness  and  apathy,  and  euphoria,  exaltation  and  ex- 
pansiveness. In  the  order  mentioned  these  five  groups 
occur  in  the  relation  8:4:3:2:i. 

During  the  past  decade  a large  amount  of  work  has  been  done 
pointing  to  correlations  of  these  “major  symptoms”  with  actual 
brain  conditions.  That  the  work  was  done  mainly  in  connection 
with  gross  and  histological  studies  of  the  nervous  system  will 
explain  why  it  was  impossible  at  the  time  to  take  up  the  work  of 
correlation  more  systematically.  The  first  labor  to  be  accom- 
plished was  to  prove  the  anatomical  basis  of  the  psychoses.  Corre- 
lations would  follow.  The  pioneer  work  was  done  by  Southard 
and  his  co-workers.  To  show  some  of  the  possibilities  we  will 
mention  the  work  in  which  three  cases  of  melancholia  with  delu- 
sions of  negation  were  shown  to  have  “nerve  cell  pigmentation 
constantly  found  in  the  elements  of  moderate  size  in  all  parts  of 
the  cortex  examined.”8  Later  (1913)  it  was  pointed  out  that 
melancholia  cases  are  delusional — the  correlation  with  pigment 
finding  was  left  to  the  future.9  In  somatic  delusions  a “peripheral 
element”  was  discovered  in  somatic  disease,  or  in  the  “sensory 
path  of  centripetal  impulses”  or  “back  of  the  Rolandic  fissure  in 
the  sensory-elaborative  areas.”10  Later  it  was  demonstrated  that 
the  characteristic  delusions  of  general  paresis  are  autopsychic  in 
nature  and  a correlation  suggested  between  them  and  frontal  lobe 
lesions.”11  Certain  symptoms  were  conveniently  grouped  as 
hyperkinetic  and  an  association  pointed  out  between  them  and 
partial  lesions  of  the  optic  thalamus.12  In  the  neuropathological 
work  on  dementia  praecox  by  the  same  worker  as  early  as  1910, 
frontal-paranoid,  cerebellar-katatonic  and  post-central-superior 
parietrl  to  katatonic  relations  are  pointed  out.13  Later  auditory 
hallucinosis  was  correlated  with  temporal  lobe  lesions;  katatonia 
and  hallucinosis  were  discovered  to  be  related  to  internal  hydro- 
cephalus, and  a certain  non-frontal  group  of  delusions  grouped 
“provisionally  under  the  term  hyperphantasia”  were  found  to 
have  a correlation  with  posterior  association  centres.14  Alzheimer, 
quoted  in  the  above,14  had  sketched  infrastellate  correlations  for 
katatonia  which  were  later  changed  to  suprastellate  ones.  More 
striking  still,  perhaps,  is  the  correlation  in  a case  showing  “striking 
scenic  visual  hallucinations”  and  “ satellitosis  of  the  common 
occipital  cortex”- — visuo-psychic  tissues. la 

In  order  to  reduce  the  facts  cited  through  the  body  of 
this  paper  to  a uniform  basis  a mathematical  method  was 
used.  By  so  reducing  all  terms  to  a common  basis  the 


Harold  I.  Gosline 


249 


comparative  value  of  terms  used  at  admission  might  be 
determined  for  the  prediction  of  the  outcome  of  the  disease 
or  vice-versa  in  picturing  the  past  of  the  disease. 

The  number  of  cases  showing  a given  symptom  at  admission 
minus  the  number  which  had  completely  deteriorated  was  used  as 
denominator  and  the  number  of  cases  now  reacting  in  a certain 
way  was  used  as  numerator  in  the  following  manner:  There  were 
38  patients  confused  at  admission- — 8 have  deteriorated — subtract 
to  give  the  number  of  patients  reacting  in  some  way  or  other  now. 
This  number,  30,  is  the  denominator. 

It  is  found  that  20  of  these  30  reacting  patients  do  so  by 
being  restless.  20  are  restless.  20  is  the  numerator. 
20/30  of  patients  who  were  confused  at  admission  and  are 
still  reacting  are  restless.  This  was  done  for  each  symptom 
and  a comparison  made  between  symptoms  at  admission 
and  now  and  between  symptoms  now  and  at  admission. 
The  comparison  was  made  possible  by  reducing  the  fractions 
so  obtained  to  the  decimal  system  whereby  numbers  are 
gained  which  are  functions  of  symptoms  and  which  make  the 
frequency  of  occurrence  of  the  symptoms  comparable  but 
which  are  purely  substitutes  for  other  means  of  description. 

It  is  possible  to  make  evidence  graphically  by  means 
of  curves  or  coordinates  that  those  who  are  violent  now  were 
at  admission  disoriented,  incoherent,  amnesic,  depressed  and 
irritable.  Those  noisy  now  were  irritable,  violent  and 
restless,  incoherent,  amnesic  and  depressed  with  equal 
frequency  and  somewhat  more  frequently  were  disoriented. 

Irritability,  restlessness,  noisiness  and  other  moderate 
reactions  did  not  play  so  large  a role  at  admission  as  they  do 
now.  The  reaction  was  then  strong  whether  demonstrated 
actively  or  not  by  outward  signs — the  reaction  now  is  weak 
or  there  is  no  reaction  at  all  notable  by  the  nurses — the 
patient  goes  on  day  by  day  like  an  automaton.  This  has 
long  been  felt  but  perhaps  not  often  presented  in  tangible 
form. 

Those  who  are  destructive  or  euphoric  pass  with  equal 
frequency  into  a state  of  mild  irritability,  restlessness, 
noisiness  and  talkativeness  though  from  the  terms  destruct- 
ive and  euphoric  and  the  attitudes  presented  by  the  patients 
corresponding  to  these  terms  one  might  expect  quite  different 
results.  (See  tables  II  and  III). 


250  The  Conduct  of  the  Insane 

It  has  been  said  that  13-15%  with  mental  anorexia  die1 

(P-  434)- 

Of  more  general  impressionistic  value  is  the  feeling  that 
the  untidy  are  those  with  arterio-sclerosis  or  organic  brain 
disease  more  often  and  why  should  the  untidiness  of  de- 
mentia praecox,  for  instance,  be  considered  less  lightly  as  a 
sign  of  brain  disease — why,  of  all  things,  should  it  be  as- 
cribed to  a disordered  will?  The  fact  that  preseniles  live 
longer  than  seniles  appeals  to  me  as  a reason  why  certain 
symptoms  should  be  considered  to  have  greater  significance 
than  others  and  thus  in  a way  to  represent  the  state  of  the 
patient’s  brain. 

In  spite  of  the  weakness  of  our  present  state'  of  knowl- 
edge of  the  subject  of  correlations,  I would  present  this 
paper,  not  as  a total  argument  but  as  a plea,  for  the  con- 
tinuation of  the  proper  use  of  words  and  scientific  observa- 
tions which  has  been  started  for  memory  of  the  various 
sorts  and  for  the  major  groups  of  psychiatric  symptoms. 

It  seems  important  that  words  used  to  represent  the 
condition  of  the  patient  should  be  accurately  chosen.  While 
not  necessary  to  psychiatry  as  a means  of  adjusting  patient 
and  friends  to  the  changed  conditions  caused  by  the  patient’s 
removal  from  the  community,  it  appears  that  such  accuracy 
is  highly  desirable  and  necessary  in  order  to  make  possible 
the  correlations  between  the  clinical  and  the  pathological 
material  which  is  the  task  of  the  future  for  the  neuropatho- 
logist. 

It  is  the  personal  belief  of  the  writer  that  such  correla- 
tions may  be  made  between  the  clinical  symptoms  themselves 
and  the  anatomical  material,  and  that  psychiatry  and  psy- 
chiatric diagnoses  are  something  else  again.  If  we  were  to 
agree  with  Arnaudu’  we  might  hesitate  at  once  to  make 
psychiatric  correlations. 

Whether  this  accuracy  in  crystallizing  clinical  symptoms 
into  words  is  to  be  accomplished  by  introducing  a new  curric- 
ulum into  some  of  our  schools  or  by  courses  of  instruction  to 
enable  our  nurses  accurately  to  describe  the  patients  is  for 
the  interested  to  decide.  As  necessary  to  the  insane  hospital 
as  the  temperature  chart  to  the  fever  hospital  is  some  method 
of  recording  the  behavior  of  the  patients — and  last  but  not 


Harold  I.  Gosline 


251 

least,  we  need  in  the  clinical  staff  of  some  of  our  hospitals 
more  zeal  for  accurate  scientific  work  that  will  make  the 
future  labors  of  the  neuropathologist  big  with  results,  both 
for  science  and  for  practice. 

CONCLUSIONS 

1.  That  the  reactions  of  patients  fall  into  two  groups, 
the  group  of  the  strong  and  that  of  the  weak. 

2.  That  the  words  used  to  describe  patients  may  be 
divided  into  three  groups,  those  of  the  purely  objective  symp- 
toms or  of  what  may  be  called  the  first  degree  of  observation; 
second,  those  which  have  some  interpretative  value  or  what 
may  be  called  the  second  degree  of  observation  and  thirdly 
those  other  major  psychiatric  symptoms  which  are  not  ob- 
jective, but  which  are  discovered  by  fairly  objective  tests 
and  which  certainly  are  not  interpretative. 

3.  That  the  objective  symptoms  of  the  first  and  third 
groups  are  of  greater  value  from  the  psychopathological 
view-point  and  for  making  clinical  pathological  correlations. 

4.  That  the  major  psychiatric  symptoms  do  occur  in 
definite  relationships.  Correlations  have  already  been 
carried  out  between  these  and  the  brain  condition. 

5.  That  there  is  some  evidence  to  show  that  the  dis- 
crepancy between  reality  and  the  phantasies  of  the  patient 
may  be  taken  as  an  index  of  brain  change  in  certain  cases. 

6.  That  the  condition  of  patients  at  admission  was 
different  from  what  it  is  now  in  most  cases. 

7.  That  moderate  reactions  did  not  play  so  large  a 
part  at  admission  as  they  do  now. 

8.  That  there  is  a tendency  to  a type  reaction  of  a 
weak  sort  independent  of  the  duration  of  the  disease. 

9.  That  patients  who  were  the  more  active  at  admission 
are  now  rather  the  less  active  ones. 

10.  That  the  mildest  reactions  are  in  general  the  ones 
that  persist  most  frequently  from  admission  to  the  present 
time. 

11.  That  psychiatry  and  psychopathology  are  two 
different  branches  of  one  science. 


252 


The  Conduct  of  the  Insane 


12.  That  psychopathology  is  necessary  for  the  work 
of  the  neuropathologist  in  the  making  of  clinical  pathological 
correlations. 


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2.  Bastian,  H.  Charlton — Appendices  to  “Hysterical  or 
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3.  Southard,  E.  E. — A Comparison  of  the  Mental  Symptoms 
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the  Fifth  Decade,  with  Remarks  on  the  Melancholia  Question  and 
Further  Observations  on  the  Distribution  of  Cortical  Pigments — 
Danvers  State  Hospital  Contribution,  No.  40. 

10.  Southard,  E.  E.  & Stearns,  A.  W. — How  far  is  the  En- 
vironment Responsible  for  Delusions? — L of  Abn.  Psychol.  June— 
July,  1913. 

11.  Southard,  E.  E.  & Tepper,  A.  _J. — The  Possible  Correla- 
tion Between  Delusions  and  Cortex  Lesions  in  General  Paresis. — 
J.  of  Abn.  Psychol.  Oct. -Nov.  1913. 

12.  Southard,  E.  E.— The  Association  of  Various  Hyper- 
kinetic Symptoms  with  Partial  Lesions  of  the  Optic  Thalamus. — 
J.  of  Nerv.  and  Ment.  Dis.  Vol.  41,  No.  9,  Sept.  1914. 

13.  Southard,  E.  E. — A Study  of  the  Dementia  Praecox 
Group  in  the  Light  of  Certain  Cases  Showing  Anomalies  or  Scler- 
oses in  Particular  Brain  Regions — Danvers  State  Hospital  Papers 
1910 — Chas.  Whitney  Page  Series. 


Harold  /.  Gosline 


253 


14.  Southard  E.  E. — On  the  Topographical  Distribution  of 
Cortex  Lesions  and  Anomalies  in  Dementia  Praecox,  with  some 
Account  of  their  Functional  Significance — Danvers  State  Hospital 
Contribution,  No.  53  & Mass.  S.  B.  I.  No.  25  (1914. 5) 

15.  Southard  E.  E. — On  the  Direction  of  Research  as  to  the 
Analysis  of  Cortical  Stigmata  and  Focal  Lesions  In  Certain 
Psychoses — Trans,  of  the  Assn,  of  Am.  Physicians — Vol.  XXIX- 
1914. 

16.  Arnaud,  F.  L. — L’Anarchie  Psychiatrique— Discourse 
Inaugural — Rev.  Neur.  XXI-Year  No.  16 — Aug.  30,  1913. 


TABLE  I 


Number 
who  show 

same  Still  Re- 
symptom acting  but 

No  now  and  Lost  Gained  not  with 

report  at  ad-  symp-  symp-  original 


Admission 

now 

mission 

Now 

tom 

tom 

symptom 

Denudative 

6 

1 

0 

8 

6 

8 

5 

Destructive 

29 

3 

3 

13 

26 

10 

23 

Incoherent 

57 

13 

0 

2 

57 

2 

44 

Irritable 

72 

17 

30 

126 

42 

.96 

25 

Manneristic 

24 

2 

1 

2 

23 

1 

21 

Masturbating 

4 

1 

1 

3 

3 

2 

2 

Negativistic 

12 

2 

1 

42 

11 

4i 

9 

Noisy 

1 

0 

1 

95 

0 

94 

0 

Obscene 

22 

2 

0 

1 

22 

0 

20 

Profane 

3 

1 

1 

48 

2 

47 

1 

Resistive 

44 

7 

9 

61 

35 

52 

28 

Restless 

59 

11 

32 

121 

27 

89 

16 

Untidy 

9 

2 

1 

37 

8 

36 

6 

Violent 

64 

11 

7 

30 

57 

23 

46 

254 


The  Conduct  of  the  Insane 


TABLE  II 

Symptoms  ol  admission  reduced  to  ioo 


Restless 

Noisy 

Aggres- 

Violent 

Irri- 

Talka- 

Pro- 

sive 

table 

tive 

fane 

Confused 

. 666 

.400 

.366 

. 200 

.666 

. 200 

• 233 

Denudative 

i .000 

.600 

.400 

. 200 

\ 600 

.400 

— 

Destructive 

.615 

.615 

■346 

. 230 

.730 

.307 

•384 

Expansive 

■444 

•555 

■444 

. 222 

.666 

•444 

444 

Exalted 

.470 

.470 

•352 

. 176 

■704 

■235 

•235 

Euphoric 

•571 

.428 

. 142 

.071 

.785 

•357 

•357 

Incoherent 

.613 

•590 

. 204 

. 227 

•545 

.408 

.250 

Irritable 

■563 

.400 

.254 

.181 

•543 

.271 

.271 

Manneristic 

.500 

. 500 

.l8l 

.136 

.636 

.227 

.090 

Negativistic 

■Soo 

.400 

.300 

. 300 

.700 

.300 

. IOO 

Obscene 

.600 

.650 

. 200 

. IOO 

.650 

.400 

.450 

Resistive 

.648 

•540 

. 270 

. 189 

•594 

.432 

.378 

Restless 

.666 

. 500 

. 29I 

.166 

.604 

. 291 

.166 

Untidy 

.857 

• 285 

— 

— 

. 285 

. 142 

— 

Violent 

.603 

■ 528 

.320 

• 132 

.566 

•283 

•339 

Resist- 

Negati- 

Destruc 

Denu- 

De- 

Drowsy 

Untidy 

ive 

vistic 

tive 

dative 

pressed 

Confused 

•233 

. 200 

— 

•033 

•133 

.066 

. 200 

Denudative 

. 200 

— 

.400 

— 

. 200 

.400 

.400 

Destructive 

.307 

. 190 

.115 

— 

.115 

.076 

. 269 

Expansive 

.222 

.ni 

— 

— 

— 

in 

.111 

Exalted 

.058 

.117 

.058 

.058 

— 

■235 

•235 

Euphoric 

. 142 

— 

.071 

— 

.142 

•214 

• H2 

Incoherent 

.318 

■ 1 13 

.090 

.022 

.090 

.090 

■159 

.090 

. 200 

Irritable 

•309 

• 236 

.090 

.072 

.127 

Manneristic 

•454 

— 

.090 

— 

•045 

.045 

.362 

— 

.300 

. IOO 

.400 

Negativistic 

. 200 

. IOO 

. 200 

Obscene 

.250 

. IOO 

. IOO 

— 

.050 

.230 

.050 

Harold  I.  Gosline 


255 


Resis- 

tive 

Negati- 

vistic 

Destruc- 

tive 

Denu- 

dative 

De- 

pressed 

Drowsy 

Untidy 

Resistive 

■243 

. 162 

.081 

.027 

— 

•I3S 

.187 

Restless 

.229 

.229 

.083 

— 

. 104 

.041 

.187 

Untidy 

00 

cl 

tJ* 

.428 

— 

.142 

.142 

— 

. 142 

Violent 

.283 

1 3 2 

.056 

•037 

•037 

.094 

. 188 

TABLE  III 

Symptoms  of  the  Present  reduced  to  ioo 


Irritable 

Violent 

Insom- 

nia 

Resist- 

ive 

Ex- 

alted 

Hom- 

cidal 

Suici- 

dal 

Rest- 

less 

Denudative 

.500 

. 250 

•125 

.125 

■ 125 

■125 

— 

— 

Destructive 

.384 

. 230 

■ 154 

.230 

.077 

.077 

•154 

•307 

Irritable 

■ 238 

• 238 

127 

.182 

.095 

■095 

•095 

. 238 

Negativistic 

■309 

. 166 

■095 

• 143 

.048 

143 

. 071 

. 262 

Noisy 

.242 

• 294- 

.115 

.052 

. 084 

.105 

us 

■273 

Profane 

.312 

■ 37S 

.166 

.312 

.083 

.146 

. 104 

.187 

Resistive 

279 

.246 

.099 

•147 

.016 

.131 

.049 

. 180 

Restless 

256 

. 264 

.091 

. 198 

.066 

H5+ 

• 132 

.272 

Untidy 

•299 

.270 

. 108 

■324 

. 108 

•US 

. 108 

. 270 

Violent 

•333 

■233 

■133 

. 266 

. 100 

•233 

. 200 

.266 

Negativ-  De- 
istic  structive 

Eu- 

phoric 

Ob-  Ex- 
scene pansive 

Appre- 

hensive 

De- 

nuda- 

tive 

Ag- 

gres- 

sive 

Denudative 

— 

— 

— 

— 

— 

— 

— 

— 

Destructive 

•154 

. 230 

077 

• 154 

— 

— 

•154 

— 

Irritable 

•°SS 

.150 

087 

• 103 

.047 

•174 

.024 

— 

Negativistic 

.024 

.119 

— 

.048 

.024 

• 238 

— 

— 

Noisy 

.031 

.147 

052 

• 137- 

.052 

. 168 

.021 

.010 

Profane 

.021  — 

.187 

104 

.187 

.083 

.187 

— 

— 

Resistive 

•033- 

■ 1 15  — 

.033- 

.072 

.033- 

. 180 

.016 

— 

Restless 

.049 

.132 

.066 

.099 

.033 

. 140 

.041 

— 

256  The  Conduct  of  the  Insane 

TABLE  III — Continued 


Negajtiv- 

De- 

Eu-_ 

Ob- 

Ex- 

Appre- 

De- 

Ag- 

istic 

structive 

phoric 

scene 

pansive 

hensive 

nuda- 

tive 

gres- 

sive 

Untidy 

. 108 

. 189 

•054 

.027 

.027 

. 162 

.034 

— 

Violent 

. 100 

•233 

•033 

.066 

.066 

.166 

— 

— 

Mute 

In-  Disori- 
different  ented 

Inco- 

herent 

Amne- 

sic 

Untidy  Se- 
clusive 

De- 

pressed 

Denudative 

.250 

. 250 

■275 

.123 

.250 

■125 

.125 



Destructive 

. 230 

•307 

— 

•307 

— 

— 

.307 

•154 

Irritable 

.079 

. 198 

.301 

. 198 

•293 

— 

•119 

.230 

Negativistic 

.119 

00 

CO 

.380 

•119 

.283 

.0  1 

1 19 

.309 

Noisy 

.084 

• i47 

- 337— 

. 252 

.294 

.021 

•137 

. 200 

Profane 

00 

0 

. 146 

. 291 

. 229 

•333 

— 

. 104 

.187 

Resistive 

• IIS 

.230 

• 393 

. 230 

•377 

.049 

O 

OO 

O 

00 

Restless 

. 091 

. 182 

• 339— 

.223 

•239 

.049 

. 140 

. 198 

Untidy 

. 270 

. 216 

.380 

. 189 

. 189 

.027 

.081 

• 135 

Violent 

• 133 

• i33 

•399 

•333 

•333 

•033 

.166 

.366 

A DISCUSSION  OF  THE  MECHANISM  OF  MENTAL 
TORTICOLLIS1 


BY  L.  PIERCE  CLARK,  M.  D. 

New  York  City 

PROBABLY  no  functional  nervous  disorder  has  a worse 
prognosis  than  mental  torticollis.  Many  cases  in- 
prove  for  a time  under  treatment.  They  may  even 
have  short  periods  of  remission  and  then  the  disorder 
may  recur  and  ultimately  defy  any  and  all  systems  of  treat- 
ment. 

The  general  mental  makeup  has  largely  been  held  to  be 
the  primary  fault  in  the  torticollitic.  It  has  been  stated 
that  the  essential  constitutional  defect  is  one  of  emotional 
infantilism.  In  this  term  is  embraced  those  defective 
instincts  which  make  the  individual  possessing  them  an 
indecisive,  vacillating  and  erratically  unstable  person.  In  a 
careful  analysis  of  several  such  persons  this  view  seems  to  be 
sustained.  All  of  the  individuals  studied  showed  abundant 
infantile  reactions  which  were  handled  fairly  well  until  the 
extra  pressure  of  some  new  adult  adaptation  was  sufficient 
to  bring  about  the  torticollis.  The  primary  fault  in  charac- 
ter was  different  from  that  seen  in  the  ordinary  neurotic  inas- 
much as  when  the  fault  was  brought  to  light  the  defect  did 
not  vanish  but  new  attitudes  had  to  be  assumed  by  these 
persons.  They  were  obliged  to  reeducate  themselves,  im- 
prove these  wreak  trends  of  the  instincts.  It  was  as  though 
their  emotional  life  had  been  arrested  or  greatly  retarded, 
and  the  defects  brought  out  in  the  analysis  had  to  be  lived 
out  or  be  made  more  adult.  Psychoanalytically  one  would 
say  these  persons  had  suffered  an  emotional  fixation  in  the 
infantile  life.  Those  who  could  be  analyzed,  in  part  at  least, 
did  not  show  these  so-called  fixations  so  sharply  as  one  sees 
them  in  other  neurotics.  It  seemed  to  be  a diffused  weakness 
of  the  emotional  trends  somewhat  comparable  to  that  seen 

257 


258  A Discussion  of  the  Mechanism  of  Mental  Torticolis 

in  dementia  praecox  cases  who  cannot  make  the  adult  emo- 
tional life.  The  feelings  of  inferiority  and  inadequacy  were 
like  those  which  one  sees  in  profound  psychasthenics.  This 
being  the  case,  one  can  understand  why  such  persons  do  not 
readily  submit  to  ordinary  psychoanalysis.  One  breaks 
down  the  morbid  mechanism  of  their  neurotic  disorder, 
but  in  doing  so  by  the  ordinary  technique  one  also  destroys 
the  framework  of  morbid  symptoms, — the  crutches,  as  it 
were,  by  which  they  get  about  though  with  such  a halting 
and  limping  gait.  The  profound  degree  of  transference 
necessary  to  get  at  these  individuals  at  all  shows  how  marked 
the  infantile  emotional  pattern  is  in  the  torticollitic.  Weeks 
and  months  of  readjustment  of  the  emotional  life  by  re- 
education must  be  instituted  between  certain  phases  of  the 
analysis.  If  one  is  not  willing  to  part  company  with  the 
strictly  technical  psychoanalytic  method  in  handling  torti- 
collitics,  then  this  line  of  treatment  will  be  of  little  avail. 
By  the  latter  aids  I believe  the  great  majority  of  cases  can 
be  cured.  Four  out  of  five  of  my  cases  are  completely  well. 
It  takes,  however,  an  enormous  amount  of  time  and  patience 
to  cure  this  disorder.  But  I believe  my  experience  has  laid 
the  way  open  to  what  can  be  done  if  we  will. 

As  regards  the  particular  type  of  muscular  movement  in 
torticollitics:  In  all  cases  I found,  first  of  all,  that  the 

torticollis  was  a defense  mechanism, — a turning  away  from 
an  adult  adaptation;  but  further  analysis  showed  that  the 
type  of  movement  was  even  more  dynamic  than  a regressive 
one  alone.  It  was  a reversion  or  regression  to  a type  of 
movement  that  had  the  deepest  pleasurable  content  in  the 
infantile  life.  In  psychoanalytic  phraseology,  they  all  were 
muscularly  autoerotic,  and  had  placed  great  dependence  upon 
these  satisfactions  in  infancy. 

In  brief,  then,  the  torticollitic  is  a profoundly  neurotic 
individual  whose  infantile  emotional  life  is  an  arrest  or 
fixation  in  a diffused  way  on  the  parent,  on  himself,  and  to 
a less  degree,  upon  his  own  sex,  and  because  of  such  an 
emotional-arrest  his  main  trends  of  character  are  weak  and 
inadequate.  In  early  adult  life  with  new  adaptations  to  the 
complicated  life  tasks  in  his  work,  and  especially  toward  the 
opposite  sex,  he  breaks  down  with  pronounced  and  out- 


L.  Pierce  Clark , M.  D. 


259 


spoken  psychoneurotic  symptoms.  Usually  the  torticollis 
is  not  a real  part  of  the  nervous  symptoms  as  they  first 
appear,  but  occur  later  with  the  more  constructive  efforts 
at  repair  of  the  nervous  illness;  it  is  then  a defense  or  a 
turning  away  from  the  intolerable  difficulties  of  life  and  a 
regression  to  certain  crude  acts  or  movements  with  an  in- 
tense satisfaction  content  to  the  unconscious,  and  therefore, 
infantile  life. 

Though  we  now  have  a fair  knowledge  of  the  makeup 
of  the  torticollitic  and  a well  detailed  pattern  of  his  infantile 
emotional  life,  as  well  as  an  interpretation  of  the  use  or 
misuse  of  the  torticollitic  movement,  we  do  not  as  yet  know 
why  this  particular  type  of  individual  uses  a torticollis  rather 
than  any  other  regression  and  infantile  mechanism.  Even 
the  union  of  a psychologic  and  a physiologic  interpretation 
does  not  yet  make  this  definite  and  clear. 


STAMMERING  DISCUSSIONS 


BY  ERNEST  TOMPKINS,  M.  E. 

A comprehensive  view  of  the  discussions  of  stammering 
shows  two  prominent  facts,  namely  much  talk,  and 
little  relief.  Since  it  is  impossible  that  the  dis- 
cussions are  thoroughly  erroneous,  we  must  con- 
clude that  mixture  of  error  with  truth  is  the  cause  of  the 
universally  admitted  confusion  of  the  subject- — the  confusion 
which  fosters  the  disorder  and  the  incomprehensible  misery 
caused  by  it.  Let  us  see  if  we  can  not  improve  our  methods 
of  discussion;  and,  for  example,  let  us  take  the  article  entitled, 
“The  Stuttering  Boy,”  published  in  the  April-May  number 
of  the  Journal,  in  which  the  author  “builded  wiser  than  he 
knew,”  although  some  of  his  premises  do  not  appear  tenable. 

On  account  of  the  confusion  caused  by  attempts  to  use 
English  words  with  the  meaning  of  similar  sounding  German 
words,  it  is  generally  necessary  to  define  “Stuttering”  and 
“Stammering”  in  order  to  make  a discussion  intelligible. 
In  English,  “Stuttering”  is  needless  repetition,  and  “Stam- 
mering” is  spasmodic  abortive  speech.  Consequently  the 
title,  “The  Stuttering  Boy,”  should  have  been  “The  Stam- 
mering Boy.”  (See,  “What  Stammering  and  Stuttering 
Stand  For,”  The  Volta  Review,  December,  1916,  and  the 
other  articles  in  that  discussion;  also,  see  the  communication 
pn  the  same  subject  in  The  Journal  of  the  American  Medical 
Association,  of  June  24,  1916). 

The  argument  of  “The  Stuttering  (Stammering)  Boy” 
is,  that  stammering,  in  the  beginning,  at  least,  is  a habit 
arising  from  the  practice  of  substituting  a polite  word  for  a 
partially-uttered  obscene  word;  and  the  argument  is  based 
to  a considerable  extent  on  the  prevalence  of  stammering 
among  small  boys,  who  are  addicted  to  coarse  terms,  and 
its  infrequency  among  small  girls,  who  are  not  much  addicted 
to  vulgar  language. 

Regarding  the  sex  disparity  of  stammering  we  have  the 


260 


Ernest  Tompkins , M.  E.  261 

following  passages.  “Have  you  ever  seen  a stuttering  girl? 
A girl,  that  is,  who  chronically  stutters.  If  so,  you  have 
observed  a phenomenon  which  is  rare,  although  stuttering 
boys  are  common  enough. ” . . . “Stuttering,  and  to  a 

less  extent  stammering  in  general  is  peculiarly  a masculine 
derangement.”  This  observation  that  stammering  is  rare 
among  girls,  and  the  conclusion  that  it  is  peculiarly  a mascu- 
line derangement  are  almost  axiomatic  in  stammering  dis- 
cussions; and  they  illustrate  the  inadvisability  of  thinking 
and  talking  in  general  terms,  practices  almost  universal 
in  the  discussion  of  stammering.  See  how  our  views  must 
change  when  we  observe  accurately. 

What  is  the  real  sex  disparity  in  stammering?  Let  us 
take  adulthood  first.  The  popular  impression  that  stam- 
mering is  rare  among  women  is  sustained.  The  sex  ratio, 
men  to  women,  is  generally  given  as  9 to  1 ; and,  since  we 
have  good  reason  to  believe  that  there  are  10  stammerers 
altogether  among  one  thousand  of  the  adult  population, 
there  will  be  1 adult  woman  stammerer  to  every  1,000  of  the 
population. 

Now  let  us  consider  the  sex  disparity  among  school 
children  in  general.  This  is  usually  given,  boys  to  girl's,  as 
3 to  I.  Notice  that  the  disparity  at  the  average  school  age 
is  only  one  third  of  that  in  adulthood.  That  is,  as  we  go 
back  from  maturity  to  youth,  the  disparity  decreases,  and 
we  should  expect  the  rate  of  decrease  to  continue  as  we  go 
toward  infancy. 

Although  there  is  dearth  of  statistics  regarding  stammer- 
ing in  infancy,  by  piecing  together  such  contributory  evidence 
as  we  can  find,  we  are  convinced  that  little  girls  stammer  as 
much  as  little  boys.  Indeed,  there  are  statistics  of  whole 
towns,  in  which  the  girls,  even  of  school  age,  stammer  more 
extensively  than  the  boys.  This  is  true  of  Tilsit,  East  Prus- 
sia, and  of  Halberstadt,  Saxony. 

But  if  little  girls  stammer  as  much  as  little  boys,  and 
if  women  stammer  much  less  than  men,  then  many  of  the 
little  girl  stammerers — specifically,  eight-ninths — must  have 
recovered;  for  stammering  is  not  contracted  extensively 
after  the  age  of  twelve.  Is  there  such  recovery?  Yes. 
The  evidence  of  it  is  all  around  us.  That  evidence  is  not 


262 


Stammering  Discussions 


emphasized  for  the  substantial  reason  that  it  is  not  to  the 
financial  interest  of  those  who  have  it.  They  find  it  more 
profitable  to  advocate  pay  treatments  than  free  treatments. 
But  even  they  bear  witness  to  the  free  treatments.  For 
instance,  Denhardt  says,  “At  times  a spontaneous  retro- 
gression of  stammering  is  observed  to  the  extent  of  dis- 
appearance even  in  youthful  age.  Sometimes  I have 
treated  stammerers  from  whom  I learned  that  the  impedi- 
ment had  afflicted  their  sisters,  but  after  a time,  and  with 
no  outside  treatment,  had  left  them  free  again.”  (Rudolf 
Denhardt;  Das  Stottern  eine  Psychose,  page  130).  Accord- 
ing to  Conradi,  “Gutzmann  gives”  (the  sex  ratio)  “2:1  for 
children  but  9:1  for  adults  and  says  with  girls  it  is  more  apt 
to  disappear  than  with  boys.  ” If  space  allowed,  quantities 
of  such  testimony  could  be  given 

We  see  then  that  the  rarity  of  stammering  among  women, 
considered  thoroughly,  leads  us  to  the  diametrically  opposite 
conclusion  to  that  reached  in  the  article  under  considera- 
tion— leads  us  to  the  conclusion  of  non-exemption  instead 
of  exemption.  It  is  as  interesting  as  it  is  sad,  that  this 
tenable  conclusion  was  surmised  years  ago,  and  might  have 
brought  about  the  entire  eradication  of  the  disorder  if  it 
had  not  been  obscured  by  the  fog  of  what  we  are  pleased  to 
consider  scientific  discussion.  Modern  writers  repeat  these 
early  surmises  with  no  appreication  of  how  they  outvalue 
the  prevailing  theories.  For  instance,  Conradi  says — 
without  endorsement — “Some  of  the  early  writers  thought 
that  the  girls  had  their  errors  corrected  by  their  mothers 
because  they  were  in  the  house  more,  whereas  boys  played 
on  the  streets  and  were  not  subject  to  correction  . 

This  brings  us  to  a meritorious  opinion  in  the  article  on  The 
Stuttering  Boy,  namely  that  originally  the  disorder  is  a 
habit.  Does  it  take  more  intellectuality  than  all  the  modern 
scientific  world  possesses  to  see  that  prohibition  of  it  at  its 
inception  would  extirpate  the  disorder?  Unfortunately, 
most  modern  writers  conclude. that  the  affliction  is  a disease, 
both  in  its  chronic  and  incipient  stages. 

Another  fault  of  our  discussions  is  the  lightness  with 
which  we  brush  aside  evidence  which  weakens  our  theories. 
In  the  article  in  question  the  evidence  of  causation  by  acci- 


Ernest  Tompkins , M.  E. 


263 


dent,  fright,  illness,  etc.,  is  discounted  without  a scintilla 
of  counter  evidence,  a proceeding  that  inevitably  leads  to 
confusion  and  mistake.  It  is  difficult  to  imagine  how  these 
causes  could  actually  be  invalidated. 

Regarding  the  time  of  the  inception  of  stammering,  the 
article  says,  “Stammering  dates  (where  the  dating  can  be 
definitely  made),  from  the  time  when  the  boy  first  went  to 
school  . . . ” Did  the  writer  know  that  the  German 

statistics  (according  to  Denhardt)  show  that  86.6%  of  the 
stammering  is  contracted  before  school  entrance?  And  if 
so,  why  did  he  not  reconcile  his  statement  and  that?  How 
can  we  agree  in  our  conclusions  if  we  disagree  in  our  funda- 
mental observations?  Indeed,  until  we  abandon  individual 
work  for  team  work,  until  we  give  credit  where  credit  is  due 
and  criticize  where  criticism  is  due,  our  alleged  scientific  dis- 
cussions will  merely  continue  to  be  what  they  have  been 
in  this  field,  a barrier  between  the  stammerers  and  the  relief 
for  which  they  have  waited  ever  since  the  beginning  of  the 
human  race. 

Many  of  the  faults  in  our  stammering  discussions  are 
due  to  lack  of  individual  experience.  One  who  has  never 
stammered  requires  extensive  experience  with  stammerers 
in  order  to  become  a competent  witness  as  to  what  the 
stammerer  thinks.  The  idea  that  the  stammerer  fears 
punishment  for  the  word  he  uses  is  fallacious.  Scripture 
says,  “If  the  question  is  asked  of  a patient  in  the  fright 
stage,  ‘Why  do  you  stutter’  (stammer)  he  will  answer  ‘Be- 
cause I am  afraid  that  I will  stutter’”  (stammer).  Indeed 
the  very  persistence  of  the  stammerer  to  utter  the  word 
which  he  had  in  mind  is  responsible  for  much  of  his  trouble. 
He  will  often  insist  on  saying  it  even  after  his  auditor  has 
caught  his  meaning  or  even  said  an  equivalent  word  for  him. 

Although  the  list  of  defects  of  our  discussions  of  stammer- 
ing is  long,  probably  one  more  defect  will  be  sufficient  in  this 
enumeration.  That  is,  the  lack  of  constructive  criticism. 
To  tear  down  an  untenable  theory  is  to  leave  the  situation 
only  a little  better  than  it  was  originally.  Whoever  desires 
to  help  the  stammerer  and  to  credit  himself  should  read  the 
recent  writings  of  Dr.  Albert  Liebmann,  particularly,  Die 
psychische  Behandlung  von  Sprachstorungen,  published  by 


264 


Stammering  Discussions 


Oscar  Coblentz,  Berlin,  1914.  The  views  therein  given  are 
not  so  complete  that  the  field  is  exhausted,  yet  they  afford  a 
foundation,  which  compared  to  most  works  on  the  subject 
is  like  rock  compared  to  chaff.  It  would  benefit  the  stam- 
merers and  elevate  the  tone  of  our  publications  if  our  articles 
on  stammering  had  such  a solid  foundation.  How  much 
longer  must  the  stammerers  wait  for  that  benefit? 


NOTES  AND  REFLEXIONS 
FROM  THE  FIELD  OF  ABNORMAL  PSYCHOLOGY 


THE  ambiguities  of  the  term  “abnormal”  come 
home  to  one  when  the  attempt  is  made  to  affix 
a name  to  the  psychologist  who  devotes  himself  to 
the  study  of  the  aberrations  and  other  anomalies 
of  the  human  mind.  The  dilemma  is  reflected  in  the  touch 
of  humor  and  the  quotation  marks  that  usually  surround 
allusions  to  the  “abnormal  psychologist!”  The  indistinct- 
ness of  this  label  is  partly  responsible  for  the  vagueness  of 
physicians  and  psychologists  as  to  the  actual  field  of  the 
abnormal.  Yet  it  is  commonly  taught  now  in  our  university 
departments  of  psychology  that  “abnormal”  is  broader  than 
“pathological,”  and  includes  many  things  in  the  study  of 
which  the  question  of  disease  does  not  necessarily  enter: 
such  as  dreams,  lapses  of  tongue  or  pen,  feats  of  lightning 
calculators,  also  the  investigation  of  prodigious  powers  of 
“memory”,  from  champion  chess  players  to  Blind  Tom,  the 
violinist,  or  similarly  endowed  memorizers  among  negro 
coat  room  attendants  at  summer  hotels! 

Dr.  Shepherd  Ivory  Franz  is  therefore  quite  right  when 
he  calls  attention  to  the  fact  that  a recent  pronouncement  of 
the  New  York  Psychiatrical  Society  uses  the  term  abnormal 
rather  than  pathological  with  the  consequence  that  “it 
would  mean  that  the  intellectually  superior  are  psychiatric 
material  as  well  as  the  intellectual  dwarfs.” 


Insight  into  Psycho- Medical  History 
Historically  it  is  perhaps  justifiable  to  treat  abnormality, 
morbidity  and  disease,  as  interchangeable  terms,  because 
their  nuances  shade  into  each  other  and  are  easily  confused. 
Moreover  as  a convenient  figure  of  speech,  the  identification 
of  any  striking  anomaly  with  disease  is  as  old  as  the  Scriptures 


265 


266 


Notes  and  Reflexions 


and  has  been  perpetuated  by  the  practical  consideration 
that  the  “doctor,”  the  “learned  one,”  should  be  called  in 
to  deal  with  anything  out  of  the  way,  be  he  priest,  medicine 
man,  or  physician. 

Nevertheless,  the  province  of  mental  anomalies  deserves 
a larger  exploitation  than  that  afforded  by  the  immediate 
appeals  of  non-plussed  laymen  faced  with  “the  Abnormal” 
as  a feature  of  personal  ill-health.  As  a “pure  science”  ab- 
normal psychology  is  demonstrating  a broader  value  in  the 
business  of  life,  because  it  is  apt  to  clear  up  the  intellectual 
premises  not  only  of  the  physician,  but  of  the  lawyer,  the 
magistrate,  the  clergyman,  the  social  service  worker,  and  of 
the  expert  in  scientific  management  or  in  personal  efficiency. 

When,  however,  it  comes  to  applying  his  specialty  to 
the  service  of  particular  individuals,  the  “anomalist”  in 
psychology  at  once  finds  that  the  region  of  “the  Abnormal” 
is  a Tom  Tiddler’s  ground.  Yet  the  very  disputation  going 
on  over  this  obscure  terrain  is  tending  to  mark  out  a field  of 
technical  usefulness  where  the  anomalist  may  by  common 
consent  exercise  his  specialty  without  becoming  a trespasser 
upon  the  domain  of  the  medical  faculty.  Indeed,  we  may 
look  for  history  to  repeat  itself  in  this  matter  after  a fashion 
that  will  parallel  the  recent  development  of  “social  service” 
as  a specialization  of  functions  once  thought  to  be  peculiarly 
reserved  for  the  clergy. 

It  is  too  easy  to  forget  that  the  acknowledged  sphere  of 
the  modern  medical  fraternity  is  a matter  of  social  evolution 
and  an  expression  of  the  law  of  diversification  of  employ- 
ments to  meet  new  demands  and  that  the  end  is  not  yet. 
A proper  viewpoint  of  the  abnormal  in  relation  to  medicine, 
as  distinguished  from  religion  and  psychology  would  seem  to 
demand  a broadening  of  the  historical  back-grounds.  One 
welcomes  therefore  a new  enlargement  of  perspective  in  this 
direction  by  a work  of  scholarship  (which  is  also  a volume 
attractively  bound  and  printed)  entitled  “The  Growth  of 
Medicine  from  the  Earliest  times  to  about  1800”  by  Albert 
H.  Buck,  B.  A.  M.  D.,  Newr  Haven,  Yale  University  Press, 
1917. 


Notes  and  Reflexions 


267 


“ Clinical  Psychologists  ” 

The  question,  Whose  Province  is  the  Abnormal,  may 
well  prove  an  “apple  of  discord!”  It  has  been  thrown  into 
the  field  of  abnormal  psychology  in  the  shape  of  that  report 
of  the  committee  of  the  New  York  Psychiatrical  Society, 
appointed  December  6,  1916,  “to  inquire  into  the  activities 
of  psychologists  and  more  particularly  of  those  who  have 
termed  themselves  ‘clinical  psychologists’  in  relation  to 
the  diagnosis  and  treatment  of  abnormal  conditions.  ” This 
report  commends,  in  one  paragraph,  the  activities  of  psy- 
chologists outside  “abnormal  mental  conditions,”  and  in 
two  more  paragraphs  views  with  alarm  the  invasion  of  the 
psychiatric  field  by  “psychological  clinics”  and  “clinical 
psychologists.  ” 

Objection  is  made  to  their  activities  being  carried  on 
“quite  independently  of  medically  trained  workers  who  are 
competent  to  deal  with  questions  involving  the  whole  mental 
and  physical  life  of  the  individual.”  The  report  closes  with 
specific  recommendations  calling  for  united  expressions  of 
disapproval  of  the  part  of  psychologists  and  physicians, 
calculated  to  discourage  such  activities. 

The  recommendations  are  chiefly  occasioned,  it  seems,  - 
by  the  fact  that  out  West  “two  States  have  enacted  laws 
permitting  judges  to  commit  mentally  defective  persons  to 
institutions  upon  the  so-called  expert  testimony  of  ‘clinical 
psychologists’  regarding  the  abnormal  mental  conditions 
from  which  patients  are  alleged  to  suffer.” 


“ Psychiatric  Experts ” 

A sprightly  discussion  of  the  tenor  and  language  of  the 
New  York  Psychiatrical  Society’s  report  is  found  in  the 
“Psychological  Bulletin”  of  June  15,  1917,  from  the  compe- 
tent pen  of  Dr.  Franz. 

“‘Expert  testimony’  is  probably  the  darkest  side 
of  medicine.  Some  have  not  hesitated  to  call  it  dis- 
reputable. When  a so-called  medical  psychiatrist 
makes  a psychiatric  diagnosis  of  ‘brain  storm,’  when 
two  so-called  psychiatric  experts,  each  with  the  same 


268 


Notes  and  Reflexions 


facts  (hypothetical  question),  testify  respectively  that 
an  individual  is  ‘sane’  and  ‘insane’  it  should  not  be 
possible  for  psychiatrists  to  affirm  that  physicians  as  a 
class  are  competent  to  make  proper  diagnoses  and  are 
the  only  ones  ‘qualified  to  deal  with  abnormal  mental 
conditions.’  If  some  states  have  decided  to  utilize 
psychologists  as  experts  regarding  the  normality  or 
abnormality  of  the  mental  states  of  individuals  it  is 
conceivable  that  it  was  done  because  previous  medical 
expert  testimony  was  not  satisfactory.  It  might  also 
indicate  that  the  West  is  more  progressive  than  the 
East.” 

The  rest  of  this  extensive  discussion  is  more  conciliatory 
than  the  excerpt  would  indicate  and  would  seem  to  call  for 
attentive  reading  from  “clinical  psychologists”  in  connection 
with  the  report  in  question.  (See  Psychopathological 
Number.) 


“ General  Psychopathology ” 

The  psychopathological  number  of  the  Psychological 
Bulletin  edited  by  Dr.  E.  E.  Southard,  is  distinguished  by 
an  extensive  review  of  psychopathology  which  is  a tour  de 
force  insofar  as  it  achieves  through  twenty  pages  a remark- 
able equilibrium  between  the  two  tendencies  in  abnormal 
psychology  so  commonly  upsetting  to  psychiatrists:  i.  e. 
the  “functional”  and  the  “organic”  view.  In  this  feat  the 
editor  is  stabilized  by  an  intellectual  balance-rod.  heavily 
weighted  at  one  end  by  Kraepelin  and  at  the  other  end  by 
Freud  and  Jung.  Between  these  two  extremes  his  own 
views  establish  a critical  connection  strengthened  by  sum- 
maries of  five  of  the  reviewer’s  most  recent  contributions. 
At  the  same  time,  this  eclectic  performance  shows  such  a 
strong  pull  toward  “functional”  views,  that  it  may  be 
regarded  as  a faithful  index  of  the  change  that  is  coming 
over  the  course  of  psychiatric  opinion. 

While  Professor  Southard’s  sponsorship  of  new  techni- 
cal terms  is  on  the  whole  happy,  it  is  not  easy  to  see  the 
need  of  this  addition  to  the  “psyche”  family:  orthopsychics. 
This  neologism  already  has  a well-grown  half-brother  in 


Notes  and  Reflexions 


269 


ortho phrenics,  which  has  done  duty  in  the  proposed  sense 
(mental  orthopedics)  long  enough  for  us  to  have  forgotten 
its  parentage.  It  is  the  old  idea  of  Re-education  in  its  pre- 
war sense;  but  served  with  Greek  roots.  Perhaps  ortho- 
phrenics  deserves  more  vogue  now  that  Re-educatio?i  is  com- 
ing to  mean  occupational  training  of  war-cripples. 


Meanings  of  u Mental  Conflict  ” 

The  changing  point  of  view  in  regard  to  the  nature 
of  the  abnormal  is  most  interestingly  revealed  in  that 
wide  movement  of  our  time  which  aims  at  substi- 
tuting corrective  and  re-educational  methods  for  the 
stereotyped  practice  of  merely  custodial  care,  whether  it  be 
in  the  field  of  criminology  or  of  so-called  insanity.  Of  this 
movement,  an  interesting  outcrop  is  Dr.  Healy’s  “Mental 
Conflicts”  which  bears  the  impress  of  a rich  experience  in 
the  study,  from  a dynamic  and  functional  standpoint,  of 
wayward  and  delinquent  youth. 

The  term  Mental  Conflicts  leads  one  to  expect  some- 
thing intimate  and  psychological  like  Prince’s  almost 
microscopic  descriptions  of  the  sub-conscious  battles  of 
dissociated  personalities.  This  sort  of  “mental  conflict” 
Prince  has  always  pictured  in  the  spirit  of  Sherrington’s 
concept  of  integrative  action;  whereas  Healy  uses  the  word 
rather  more  broadly  and  impressionistically.  But,  as  Pro- 
fessor Southard  learns,  Dr.  Healy  regards  strict  definition 
of  the  process  of  mental  conflicts  as  unnecessary,  a position 
which  would  stand  self-explained  if  reviewers  would  quote 
the  full  title:  “Mental  Conflicts  and  Misconduct.”  (Little, 
Brown  & Co.,  Boston,  1917.) 


Psychomachy  and  the  F.  C.  P . 

In  his  editorial  on  “General  Psychopathology, ” Pro- 
fessor Southard  takes  a somewhat  pessimistic  view  of  our 
present  understanding  of  mental  conflicts:  “It  is  a pretty 
far  cry  from  the  competition  between  extension  and  flexion 
to  intrapsychical  conflicts” — “Up  to  date,”  he  says  further, 
“we  have  little  more  than  ethical  theories  such  as  would  be 


270 


Notes  and  Reflexions 


quite  within  the  range  of  understanding  of  eighteenth 
century' moralists  in  relation  to  ‘psychomachy’.  ” 

In  this  connection  the  student  of  “psychomachy”  in 
its  traditional  sense  would  find  some  very  illuminating 
suggestions  of  a Sherringtonian  type  if  he  would  turn,  not 
to  the  eighteenth  century  but  back  to  the  seventeenth;  in 
particular  to  Descartes’  treatise  on  the  Passions  of  the  Soul, 
article  47,  entitled,  “Wherein  consists  those  combats  which 
it  is  customary  to  imagine  as  taking  place  between  the  in- 
ferior and  the  superior  portions  of  the  soul.  ” Mutatis 
mutandis , “the  inclinations  of  the  pineal  gland”  of  Descartes 
make  a very  good  algebraic  symbol  of  the  competition  for  the 
final  common  pathway.  Adding  to  this  the  fact  that  Sher- 
rington has  acknowledged  his  indebtedness  to  Descartes  for 
the  ideas  of  reciprocal  innervation,  one  might  perhaps  con- 
strue the  hint  that  on  “psychomachology ” a great  deal  has 
been  written  which  is  being  ignored  merely  because  it  has 
not  caught  the  attention  of  the  popularizer. 

A similar  state  of  affairs  explains  the  apparent  priority 
of  Freud  in  the  field  of  infantile  shocks , and  in  association 
neuroses : yet,  as  Dr.  C.  G.  Jung  has  pointed  out,  it  might 
be  well  even  for  psychoanalysts  to  read  what  has  been  said 
earlier  in  English  and  in  French  on  these  subjects.  If  this 
suggestion  were  followed  we  would  perhaps  hear  that  a 
large  part  of  the  Freudian  discovery  is  “Johnny  Thompson’s 
news.  ” 


The  Demand  for  Unifying  Views 
In  the  Survey,  July  21,  1917,  Professor  R.  S.  Woodworth 
gives  a critique  of  Dr.  White’s  book  on  mechanisms  of 
character  formation,  in  the  course  of  which  the  following 
interesting  judgment  reveals  a divergence  of  point  of  view 
from  psychoanalysts.  The  book’s  teaching,  he  says,  “is 
rather  obscured  than  clarified  by  the  vague  philosophy  of 
life  and  of  the  universe  which  the  author,  in  common  with 
many  of  the  school,  delights  in  spinning  about  the  facts  of 
their  practice.  ” 

It  would  seem  that  the  laboratory  man’s  point  of  view 
is  somewhat  too  severely  scientific.  The  desire  for  a Welt- 


Notes  and  Reflexions 


271 


anschauung  is  not  to  be  gainsaid,  and  it  is  pertinent  to  all 
the  work  of  the  Freudians  and  related  schools  to  remember 
that  a prime  motive  in  the  spinning  of  theories  is  to  bring 
unity  in  the  concept  of  the  neuroses.  This  striving  the 
patients  themselves  are  already  so  deeply  engaged  in  that 
it  is  pardonable  when  the  psycho-medical  student  seeks  to 
envelop  the  symptoms  and  the  cure  in  some  sort  of  philo- 
sophical system.  It  is  also  relevant  to  state  that  several 
psycho-analysts  whose  names  are  prominent  in  the  trans- 
lations of  books  from  the  Vienna  and  Zurich  schools  confess 
that  the  great  attraction  of  psycho-analytic  doctrine  is  its 
power  to  bring  a sense  of  unity  to  their  scheme  of  life  as  well 
as  to  their  medical  practice.  It  is  this  broader  element, 
albeit  extra-scientific,  which  has  no  doubt  led  to  the  circula- 
tion of  the  rumor  that  the  psycho-analysts  of  the  Zurich 
group  were  threatened  with  special  taxes  on  the  grounds  of 
being  a religious  body. 


A Case  of  Dementi 

Linguistic  lapses  have  occupied  the  attention  of  several 
psychologists  under  the  recent  inspiration  of  Freud’s  psycho- 
pathology of  everyday  life.  But  it  is  not  often  that  one 
studies  the  lapses  of  the  linotype  in  the  printing  office.  Such 
typographers’  errors  abound  in  inversions  of  letters,  sub- 
stitutions, and  additions,  quite  as  significant  sometimes  as 
any  lapses  of  tongue  or  pen.  In  the  case  of  a recent  daily 
paper  article  on  the  denials,  issued  from  Berlin,  touching 
Ambassador  Gerard’s  revelations,  one  could  read  that  a 
new  construction  was  being  placed  upon  the  Kaiser’s  telegram 
by  “the  dementia  f dementi j of  the  Foreign  Office.” 


Shock  Troops 

Popularization  seems  to  require  that  everything  Ger- 
man should  be  presented  as  “the  latest  thing  out.” 

By  a curious  inversion  of  ideas  a weekly  journal,  The 
Literary  Digest , refers  to  the  use  of  shock  troops  under  the 
title  “German  shock  absorbers.” 


272 


Notes  and  Reflexions 


“Armies,  like  automobiles,  when  thoroughly  up 
to  date,  must  be  equipped  with  shock-absorbers.  This 
is  the  latest  discovery  of  German  efficiency,  and  Stoss- 
truppen , or  shock  units  of  about  four  hundred  men  each, 
are  now  attached  to  each  army  corps.” 

Obviously,  it  is  not  to  absorb  and  thus  to  cushion  the 
shock  that  these  troops  are  used,  but  on  the  contrary  to 
inflict  a telling  blow  at  any  expense,  even  to  the  destruction 
of  the  shock  troops  themselves.  The  usual  phrase  “shock 
absorber”  is  here  evidently  mis-applied  since  shock  ab- 
sorption is  a defensive  and  not  an  offensive  activity.  Shock- 
giving is  the  idea.  In  this  sense  shock  troops  are  not  new 
but  a device  as  old  as  the  archers  and  sling  bearers  that  used 
to  be  sent  on  ahead  of  the  lancers  and  horsemen  “to  begin 
the  shock.”  This  phrase,  “pour  commencer  le  choc”  was 
used  as  a figure  of  speech  in  the  seventeenth  century  in 
relation  to  arguments. 

The  same  article  goes  on: 

“American  correspondents  at  the  French  front  tell 
us  that  the  ‘shock  units’  are  specially  formed  for  difficult 
operations  which  the  ordinary  regiments  evidently  are 
regarded  as  unqualified  to  undertake,  and  are  formed 
from  among  the  young,  vigorous  men  of  the  regular 
battalions.  ” 

It  is  undoubtedly  efficient  to  take  into  account  the 
peculiar  characteristics  of  the  individual  troopers;  and  to 
specialize  the  “determined  characters”  and  the  atavistic 
“cave-men”  of  the  army.  But  to  say  that  this  specializa- 
tion of  function  is  a miracle  of  German  efficiency  is  to  under- 
rate the  past.  In  the  time  of  Philip  the  Second  of  France 
(1165-1223),  such  shock  troops  were  well  established  in  the 
military  scheme.  They  were  known  as  ribaldi,  after  a 
certain  Captain  Ribauld,  and  on  account  of  their  desperate 
character  and  abandoned  morals  gave  rise  to  the  present 
meaning  of  the  word  ribald. 

Nor  is  there  anything  new  in  the  type  of  vocational 


Notes  and  Reflexions 


273 


guidance  (saving  the  mark!)  which  the  Germans  are  alleged 
to  be  employing  by  sending  their  political  undesirables  as 
well  as  their  rough  characters  into  the  exposed  wave  lines 
of  the  shock  troops.  The  only  credit  that  can  be  given 
for  novelty  along  this  line  is  an  attempt  recently  made  by 
the  Germans  to  utilize  in  a military  way  the  inmates  of 
insane  hospitals — an  experiment  which  is  understood  to  have 
failed,  but  concerning  which  it  would  be  interesting  to  ob- 
tain fuller  details. 


War  Shock 

“Shell  Shock  and  its  Lessons”  by  G.  Eliot  Smith  (1916, 
Longmans  Green  and  Company),  contains  a solid  suggestion 
of  the  medical  growth  toward  the  realization  of  the  purely 
psychic  element  in  mental  disorder.  Its  testimony  as  to 
the  importance  of  grasping  the  psychology  of  war  shock  is 
being  continually  reinforced  by  the  medical  reports  from  the 
theaters  of  war. 

To  American  students  of  abnormal  psychology  the  topic 
of  war  shock  opens  up  many  comforting  vistas;  when  one 
has  knuckled  down  for  years  to  the  cut-and-dried  Linnaean 
classification  of  the  Kraepelin  herbarium  of  abnormal 
human  nature,  it  is  a relief  to  see  the  dynamic  and  biological 
point  of  view  vindicated  in  the  clinics  of  the  war.  We  begin 
to  have  the  right  to  take  a fresh  look  at  many  of  the  psycho- 
neuroses from  a stand  point  which  is  neither  that  of  Kraepelin 
nor  that  of  Freud,  but  a point  of  view  which  has  developed 
independently  on  this  side  of  the  water  from  the  French  and 
Swiss  School  under  the  influence  of  men  like  Janet,  Prince, 
Meyer,  and  Hoch. 


Disease  Entities  in  Psychiatry 
Adolph  Meyer  has  never  given  the  impression  of  being 
a partisan  of  the  Kraepel-Linnaean  system  of  classification; 
but  his  position  as  a Liberal  in  Psychiatry  has  perhaps  never 
been  more  succinctly  outlined  than  in  two  paragraphs  which 
appear  as  a preface  to  a review  of  Healy’s  “Mental  Conflicts 


274  Notes  and  Reflexions 

and  Misconduct.”  These  we  reprint  below  from  the  Survey 

of  August  ii,  1917. 

“Those  of  us  who  have  watched  the  development 
of  the  American  work  in  criminology,  and  especially 
the  share  of  psychopathology,  look  upon  the  past  few 
years  as  the  period  cf  the  first  fruition  of  a new  move- 
ment. It  has  become  possible  through  a change  in  the 
medical  attitude  towards  psychopathological  facts. 
Up  to  but  a few  years  ago,  the  physician’s  idea  of  the 
recognition  of  a morbid  condition  or  of  a ‘diagnosis’  was 
a matter  of  identification  of  the  particular  case  with  a 
type  of  lesion  or  with  a sanctioned  clinical  entity,  some- 
thing entitled  to  some  definite  name;  from  this  identi- 
fication under  a definite  concept,  of  which  the  facts  at 
hand  were  but  symptoms,  the  physician  could  then 
proceed  to  make  certain  deductions  with  regard  to  the 
nature,  cause,  course,  and  outcome  of  the  disorder; 
deductions  which  usually  were  deemed  impossible  from 
the  mere  facts  as  observed  by  the  uninitiated. 

“A  great  change  has  come  through  a growth  of 
confidence  in  the  facts  as  they  actually  can  be  observed 
and  in  our  study  of  them.  From  a method  of  excessive 
confidence  in  rationalizing  and  systematizing,  we  have 
come  to  a method  of  greater  confidence  in  the  facts  open 
to  trained  observation  and  in  the  help  to  be  derived  from 
having  enough  facts,  and  not  merely  a central  diagnosis. 
This  development  conflicts  with  the  limitations  culti- 
vated by  both  legal  procedure  and  medical  tradition, 
but  who  can  deny  that  this  emancipation  is  or  promises 
to  be  one  of  the  greatest  elements  in  putting  human 
judgment  concerning  the  management  of  human  affairs 
on  a sound  common-sense  basis  free  of  dogmatic  limi- 
tations and  yet  open  to  all  progress  and  gains  derived 
by  scientific  methods?” 


Army  Psychopathology 

It  is  fortunate  for  our  new  armies  that  the  psycho- 
medical point  of  view  is  being  represented  by  a group  of 


Notes  and  Reflexions 


275 


broad-minded  men  associated  with  the  Medical  Corps. 

The  Surgeon-General’s  office  has  from  time  to  time 
announced  the  program  for  dealing  with  men  nervously  or 
mentally  unfit  for  service  in  the  Army.  These  announce- 
ments have  related  principally  to  the  examinations  which 
have  been  conducted  for  detecting  symptoms.  Major 
Pearce  Bailey  of  the  Medical  Reserve  Corps  has  organized 
this  work  in  connection  with  some  of  the  most  distinguished 
psychiatrists  and  neurologists  of  the  country.  It  will  be  re- 
called that  Dr.  Pearce  Bailey  was  made  Chairman  of  the 
Committee  on  Furnishing  Hospital  Units  for  Nervous  and 
Mental  Disorders  to  the  United  States  Government;  this  is 
a sub-committee  of  the  National  Committee  of  Mental 
Hygiene. 

It  is  announced  that  men  will  be  excluded  from  military 
service  for  any  nervous  disease  such  as  locomotor  ataxia; 
for  mental  defects  sufficient  to  class  them  as  defectives;  for 
insanity  or  a definite  family  record  of  it;  and  for  chronic 
addiction  to  drugs  or  alcohol. 

One  or  another  of  about  150  specialists  will  be  detailed 
to  cantonments  and  later  will  be  transferred  to  hospitals 
abroad  to  supervise  the  care  of  nervous  casualties  as  the 
necessity  arises. 

It  is  too  early  to  say  anything  about  the  satisfactoriness 
of  this  weeding-out  process  or  about  the  specific  methods  of 
treatment  abroad;  except  that  it  is  plainly  stated  that  an 
exceedingly  liberal  policy  will  be  followed  in  dealing  with 
cowardice,  the  cases  of  which  will  be  scrutinized  from  a new 
angle,  that  of  the  psychology  of  the  emotions. 


Hindu  Mind  Training  and  Re-education 
The  Freudians  are  rather  sensitive  about  having  their 
cathartic  method  identified  with  the  educational  treatment  of 
nervous  disorders  as  brought  forward  by  Morton  Prince 
1898).  Not  so  the  Hindus,  for  with  them  the  psychology  of 
mind-training  is  the  corner-stone  of  religious  philosophy. 

In  view  of  the  present  gap  between  psychological  analysis 
(Janet)  and  psychoanalysis  it  is  not  uninteresting  to  see  the 
modern  psychological  trends  reviewed  from  the  stand  point 


276 


Notes  and  Reflexions 


of  a Hindu.  “Hindu  Mind  Training”  by  “An  Anglo- 
Saxon  Mother”  and  S.  M.  Mitra  is  a peculiar  blend  of 
modernity  and  Hinduism  (Longmans,  Green  & Co.)  Its 
refrain  seems  to  be  “thirty  centuries  ago”;  but  the  table  of 
contents  abounds  in  references  to  such  recent  teachings  as 
those  of  the  school  of  “Descartes  and  Locke,”  Hollingworth 
and  Titchener,  Montesorri,  Freud,  Kant,  Lombroso,  E.  B. 
Holt,  G.  W.  Crile,  and  C.  G.  Jung,  a potpourri  of  names  and 
references  suggesting  an  overweening  desire  to  unite  Hin- 
duism and  modernism  in  psychology. 

Even  from  the  vantage  point  of  “thirty  centuries  ago” 
it  is  a little  startling  to  have  our  author  speak  of  the  school 
of  “Locke  and  Descartes.”  This  implies  vision  from  a high 
altitude  indeed,  since  a chasm  still  separates  the  thinkers  of 
the  Lockean  type  from  those  of  the  Cartesian  school. 

But  this  aeroplaning  through  psychology  is  not  with- 
out its  piquancy  of  outlook,  as  for  example  the  following 
glimpse: 

“The  ancient  Hindu  sages  anticipated  Western 
‘suggestion’  by  about  thirty  centuries.  Subtle  students 
of  this  volume  will  at  once  see  how  ‘suggestions’  can  be 
veiled  in  questions.  The  ancient  Hindus  recommended 
hypnotism  only  in  cases  in  which  ‘suggestion’  while 
conscious,  as  shown  in  this  volume,  had  failed.  So  they 
anticipated  the  famous  American  psychotherapist, 
Mor.ton  Prince,  by  about  thirty  centuries.” 

May  we  suggest  that  “An  Anglo-Saxon  Mother”  and 
her  gifted  collaborator,  Mr.  S.  M.  Mitra,  would  more 
quickly  reach  their  goal  (namely  to  reduce  all  psychology 
to  Hinduism)  by  simply  assuming  that  Dr.  Morton  Prince 
and  other  students  of  the  sub-self  had  labored  together 
originally  as  Hindus  in  a previous  incarnation  “thirty  cen- 
turies ago!” 

In  any  case  it  must  be  said  that  there  is  no  such  common 
denominator  between  oriental  psychology  and  western 
psychology  as  the  authors  try  to  make  out.  There  is,  how- 
ever, as  they  do  well  to  indicate,  a great  deal  to  learn  from 
the  Hindu  method  of  training  children’s  minds  and  develop- 


Notes  and  Reflexions 


2 77 


ing  their  souls  by  kindergarten  methods  such  as  the  telling 
of  fables.  But  Hindu  folk-lore  tales  are  no  better  for  the 
purposes  of  western  minds  than  the  fables  of  LaFontaine  or 
Kipling’s  “Just  So  Stories.”  And  we  think  the  attempt  to 
put  the  new  wine  of  modern  mind-training  into  the  old  bottles 
of  Hinduism  is  not  likely  to  succeed  otherwise  than  as  a fad. 


REVIEWS 


mentally  defective  children.  By  Alfred.  Bitiet  and  Th. 
Simon;  authorized  translation  by  W.  B.  Drummo?id,  zuith  an  Appen- 
dix by  Margaret  Drummond.  Longmans,  Green  & Co.,  1914, 
New  York.  Pp.  xi  + 180.  Price  $1.00  net. 

This  book  is  a translation  of  Les  Enfants  anormaux;  guide  pour 
r admission  des  enfants  anormaux  dans  les  classes  de  perfectionne- 
ment.  Paris,  1907.  The  translator  does  not  himself  give  the 
French  title  or  the  date  of  publication  of  the  work  which  he  has 
translated.  The  book  was  written  shortly  after  the  article  ap- 
peared, in  L'Annee  Psychologique  of  1905,  in  which  Binet  and 
Simon  first  set  forth  their  proposals  for  a method  of  measuring 
intelligence,  and  is  intended  to  serve  as  a guide  to  the  methods, 
pedagogical,  psychological,  and  medical,  for  selecting  pupils  for 
the  special  schools  or  classes.  In  an  Appendix  a condensed  state- 
ment is  added  of  the  1911  revision  of  the  tests.  The  article,  in  the 
Bulletin  de  la  Societe  Libre  pour  F Etude  Psychologique  de  V Enfant, 
in  which  this  revision  appeared  was  translated  in  1913  by  Clara 
H.  Town.  With  the  publication  this  year  of  translations  by 
Elizabeth  Kite  of  all  the  articles  of  Binet  and  Simon  in  L'Annee 
Psychologique  in  the  years  1905,  1908  and  1911  dealing  with  the 
subject  of  the  development  and  measurement  of  intelligence  in 
children,  the  chief  writings  of  Binet  and  Simon  on  this  subject  are 
now  available  in  English. 

W.  F.  Dearborn. 

manual  of  psychiatry.  By  Rogues  De  Fursac  and  A.  J . 
Rosanoff.  Fourth  Edition.  New  York:  John  Wiley  & Sons,  1916. 
Price  $2.00  net.  Pp.  XI,  522. 

In  this  latest  edition  of  the  well-known  Manual  the  translator 
has  become  the  collaborator.  The  brackets  which  formerly  indi- 
cated material  added  by  him  have  been  omitted  (except  here  and 
there  by  inadvertence),  and  the  translator’s  appendices  of  the 
previous  edition  are  here  incorporated  in  the  main  text.  Some 
verbal  changes  have  been  made  for  the  better,  as  “involutional” 
for  “affective”  melancholia,  “institution”  for  “asylum,”  “psycho- 
sis” for  “insanity,”  and  others.  An  index  of  authors  has  been 
added,  and  the  subject-index  has  been  enlarged  by  a page  and  a 
half. 

Also,  “the  chapters  dealing  with  etiology,  history  taking, 
methods  of  examination,  special  diagnostic  procedures,  general 
prognosis,  prevalence  of  mental  disorders,  prevention,  and  medico- 
legal questions”  and  on  “Huntington’s  chorea,  cerebral  syphilis, 


278 


Reviews 


279 


and  traumatic  psychoses  are  either  wholly  new  or  almost  so;”  the 
chapters  on  “general  therapeutic  indications,  dementia  praecox, 
chronic  alcoholism,  general  paresis,  and  mental  disorders  due  to 
organic  cerebral  affections  . . . have  been  more  or  less  ex- 

tensively revised  or  added  to;”  and  “the  remaining  chapters  have 
also  been  carefully  gone  over  and  corrected  or  altered  whenever  it 
seemed  necessary  or  advisable  to  do  so.  ” 

Much  of  the  new  material  has  enhanced  the  value  of  the  book, 
especially  the  parts  dealing  with  history  taking,  mental  and 
physical  examination,  and  diagnostic  procedures,  part  of  which 
was  in  the  appendices  of  the  third  edition,  and  the  last  part  of  the 
chapter  on  general  paresis,  with  the  chapters  on  cerebral  syphilis 
and  Huntington’s  chorea. 

Apparently  for  the  sake  of  consistency  with  the  position  that 
there  are  four  essential  causes  of  mental  disease — heredity,  alcohol, 
syphilis,  and  head  injuries — the  classification  and  order  of  presenta- 
tion of  the  psychoses  has  been  quite  changed,  with  the  result  that 
there  are  some  strange  groups  of  bed-fellows.  The  first  group,  the 
constitutional  disorders,  comprise  feeble-mindedness,  epileptic 
psychoses,  dementia  praecox,  paranoia,  manic-depressive  psychoses, 
involutional  melancholia,  other  psychopathic  conditions  (i.  e. 
hysteria,  constitutional  psychopathy,  moral  insanity),  and  Hunt- 
ington’s chorea.  The  next  three  groups  are  more  homogeneous, 
though  cerebral  arteriosclerosis  is  classed  under  the  syphilitic 
disorders.  But  the  scheme  forces  into  a fifth  or  “miscellaneous 
group”  the  infective,  exhaustive,  drug  (other  than  alcohol),  auto- 
toxic and  thyrogenic  psychoses  together  with  those  due  to  such 
cerebral  conditions  as  tumors,  abscess,  multiple  sclerosis  and 
central  neuritis,  and  the  senile  psychoses.  One  may  not  quarrel 
with  this  grouping,  since  each  author  is  privileged  to  make  his  own, 
and  this  has  a certain  internal  consistency. 

In  a revision  in  which  there  was,  as  the  collaborator  says  in  his 
preface,  “an  opportunity  of  bringing  this  manual  up  to  date, 
in  view-point  as  well  as  in  subject  matter,”  there  are  some  signi- 
ficant omissions.  For  example,  a scant  page  is  given  to  Freud’s 
psychoanalytic  conceptions,  and  no  further  mention  is  made  of 
them.  The  word  “complex”  is  not  indexed,  and  is  mentioned 
only  in  connection  with  psychotherapy.  Hence,  in  the  sections  on 
delusions,  hallucinations,  and  psychotherapy  and  in  many  of  the 
clinical  chapters  the  author  does  not  seem  to  have  taken  advantage 
of  real  contributions  that  Freud  and  his  followers  have  made  to 
psychiatry.  One  may  recognize  the  value  of  these  without  neces- 
sarily accepting  their  interpretations  in  toto.  Then,  it  is  surely 
not  modern  to  speak  of  “exaltation  of  memory,”  “exaggeration 
of  consciousness,”  etc.  And  the  method  of  presentation  of  the 
psychoses  is  largely  that  of  description  in  general  terms;  little  can 
be  found  of  genesis,  interpretation,  development,  or  explanation  of 


28o 


Reviews 


psychoses  or  their  symptoms,  yet  the  trend  of  modern  psychiatry 
has  been  in  these  directions. 

These  are  but  the  most  obvious  of  the  failings  of  this  edition. 
Perhaps  to  correct  them  all  would  involve  such  a re-writing  as 
would  make  the  original  hardly  recognizable, — a task  not,  how- 
ever, beyond  the  ability  of  the  collaborator.  But  in  spite  of  them 
all,  the  fact  that  a fourth  edition  is  in  demand  shows  that  there  is 
room  for  it  among  American  text-books. 

E.  Stanley  Abbot. 

McLean  Hospital,  Waverley. 

PROCEEDINGS  OF  THE  AMERICAN  SOCIETY  FOR  PSYCHICAL  RE- 
SEARCH. Vol.  IX,  August,  1915,  Part  1;  Vol.  X,  August,  1916, 
Part  2;  and  Vol.  XI,  August,  1917. 

The  first  two  volumes  here  mentioned  are  given  up  to  a com- 
plete presentation,  with  full  history  and  description,  and  con- 
clusions, of  “The  Doris  Case  of  Multiple  Personality”  by  Walter 
Franklin  Prince,  Ph.  D.  The  report  consists  of  1332  pages  with 
87  pages  of  index.  The  report  begins  with  a preface,  followed  by- 
chapters  devoted  to  introduction  and  summary  (which  gives  the 
general  conclusions  arrived  at  byr  the  author),  and  then  follow 
full,  minute  descriptions  of  the  first  period  of  undivided  personality, 
the  second  period  of  three  personalities,  the  third  period  of  four 
personalities,  the  fourth  period  of  five  personalities,  the  fifth 
period  or  the  beginning  of  curative  influences,  the  sixth  period  or 
the  campaign  begun,  the  seventh  period  with  the  patient  under 
changed  environment,  the  eighth  period  or  quadruple  personality, 
the  ninth  period  with  triple  personality,  and  the  tenth  period  with 
recovery  of  normal  consciousness.  Then  follows  the  record  of 
automatic  writing,  and  two  very  brief  appendices. 

The  author,  Prince,  in  a paper  published  in  the  Journal  of 
Abnormal  Psychology  for  June-July,  1916,  entitled  “The  Doris 
Case  of  Quintuple  Personality,”  gave  an  abstract  of  the  case  for 
the  readers  of  the  Journal.  For  this  reason  it  is  unnecessary  for 
me  to  present  an  abstract  of  the  case  in  this  review. 

All  sorts  of  problems  are  brought  up  for  consideration  by 
this  particular  case.  Since  this  work  is  the  result  of  continued 
daily  observation  and  study  of  this  patient  for  more  than  three 
years,  one  can  well  appreciate  how  thorough  the  history  and  the 
record  of  observations  are.  The  published  record  of  the  case  is 
the  longest  on  record  of  all  cases  of  multiple  personality  so  far 
published,  not  excluding  the  works  of  Morton  Prince  and  Boris 
Sidis. 

As  a matter  of  fact  the  record  of  observations  and  conversa- 
tion is  so  long  and  given  so  much  in  detail  that  it  is  a question 
whether  there  are  many  who  will  read  the  full  report.  The  com- 
plete index  which  concludes  the  first  two  volumes  is  of  great  aid 


Reviews 


281 


in  permitting  one  to  read  the  record  for  any  particular  aspect  of 
the  case  in  which  one  may  be  especially  interested. 

The  great  expenditure  of  effort  and  the  infinite  care  and 
tremendous  interest  which  were  necessary  for  the  compilation  of 
the  record  now  offered  us,  is  admirable  and  astonishing.  Not 
many  men  are  capable  of  such  continuous  application  and  per- 
sistence as  one  finds  evidence  of  in  this  work  on  the  part  of  Prince 
and  Prof.  Hyslop  who  is  partner  and  contributor  in  these  efforts. 

Those  who  are  more  expert  in  the  study  of  cases  of  multiple 
personality  than  I,  are  in  a better  position  to  critically  examine 
this  case  and  agree  or  disagree  with  the  various  conclusions  of  the 
authors.  But  it  must  be  said  that  no  one  who  is  in  the  least  con- 
cerned with  the  great  question  of  dissociation  of  personality  can 
afford  to  neglect  the  work  under  consideration.  It  is  a record 
which  many  will  study  in  the  energies  to  be  expended  upon  the 
solution  of  this  problem  in  the  future. 

The  third  volume  consists  of  1024  pages,  of  which  67  pages 
form  the  index,  all  written  by  Prof.  James  H.  Hyslop.  It  com- 
prises the  report  of  “The  Patison  Case,”  with  an  introduction, 
discussion  and  detailed  record,  of  a child  who  has  exhibited  re- 
markable ability  in  dancing.  The  first  part  of  this  volume  is  a 
lengthy  discussion  by  Prof.  Hyslop  of  “The  Doris  Case  of  Multiple 
Personality,”  with  an  introduction,  examination  of  hypotheses 
and  detailed  record. 

Hyslop  believes  that  obsession  by  discarnate  spirits  is  account- 
able for  these  two  cases.  In  his  discussion  of  the  Doris  Case  of 
Multiple  Personality  he  offers  the  interesting  suggestion  or  modi- 
fication of  the  views  generally  held  by  believers  in  this  super- 
normal phenomenon  that  some  cases  of  obsession  may  be  primarily 
instigative  and  others  primarily  transmissive.  In  other  words, 
in  some  cases  the  spirits  themselves  do  the  work  (the  so-called 
transmissive  cases)  and  are  directly  responsible  for  the  productions, 
while  in  other  cases  they  only  initiate  the  process  (the  so-called 
instigative  cases)  the  individual  personal  doing  the  rest.  In  this 
latter  instance  he  would  claim  that  obsession  of  the  instigative 
type  does  not  exclude  the  existence  of  true  secondary  personality. 

Without  entering  into  a discussion,  pro  and  con,  of  these  ideas, 
I may  make  but  a single  point  in  this  connection.  If  the  spirits 
or  obsessional  possession,  either  transmissive  or  instigative,  are 
responsible  or  can  be  responsible  for  the  Doris  Case  of  Multiple 
Personality  and  for  the  Patison  Case  of  possession  of  unusual 
powers  or  gifts,  what  is  there  to  prevent  us  from  applying  this  same 
explanation  to  all  of  the  following  classes  of  phenomena?  Why, 
if  these  views  apply  to  the  cases  mentioned  by  Hyslop,  must  they, 
as  a positive  and  logical  conclusion  forced  by  reasoning  from  fact 
to  fact,  of  necessity  not  apply  to  every  possible  case  of  dissociation 
of  the  personality  of  consciousness,  of  slight  or  great  degree,  of 
momentary  or  prolonged  duration?  This  would  include  cases 


282 


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of  so-called  hysteria  (a  vague  term),  of  what  Freud  has  called 
psychopathological  acts  of  everyday  life,  of  dreams,  of  the  produc- 
tions of  mentally  disturbed  persons  (in  deliria  of  toxic  origin,  in 
so-called  dementia  precox,  manic-depressive  psychoses  and  the 
rest) — in  fact  of  all  expressions,  ideational  or  otherwise,  in  func- 
tional or  even  organic  disorders  accompanied  by  abnormal  (un- 
usual or  uncommon)  activities  or  manifestations.  Why  must 
these  ideas  not  be  applied  to  the  usual,  normal,  everyday  phenom- 
ena, since  they  differ  from  the  unusual,  abnormal,  phenomena 
mainly  in  degree?  Hence  we  must  include  dreams,  and  all  waking 
normal  activities,  ideational  and  otherwise?  This  latter  con- 
clusion is  further  forced  upon  one  if  one  attempts  to  explain  all 
manifestations  of  genius  and  marked  ability  in  this  manner,  for  it 
it  but  a step  to  include  all  sorts  of  ability,  every  type  of  behavior. 
And  why  stop  with  behavior  or  reactions  of  human  beings  only? 
Why  not  include  the  reactions  of  animal  life — in  fact  all  manifesta- 
tions of  life,  from  the  lowest  to  the  highest  rung?  Seriously  this 
is  the  final  conclusion  to  which  one  is  forced.  And  this  means 
nothing  more  than  reincarnation  of  one  sort  or  another. 

There  is  no  question  but  that  the  question  of  survival  after 
death  and  of  communication  with  and  by  spirits  has  been  brought 
anew  to  the  attention  of  educated  persons  very  forcibly  by  the 
reading,  at  least  as  evidenced  by  the  reported  big  circulation,  of 
Sir  Oliver  Lodge’s  recent  book  entitled  “Raymond,  Or  Life  and 
Death.”  The  war,  to  be  sure,  will  contribute  in  great  measure  to 
this  end. 

Meyer  Solomon. 

THE  PSYCHOLOGY  OF  SPECIAL  ABILITIES  AND  DISABILITIES.  By 

Augusta  F.  Bronner,  Ph.  D.,  Assistant  Director  of  the  Juvenile 
Psychopathic  Institute , Chicago.  Boston:  Little,  Brown  & Com- 

pany. $1.75  net.  Pp.  269. 

H ere  is  the  sort  of  book  that  many  of  us  have  been  waiting 
for  for  some  time.  We  have  seen  evidences  of  the  general  truths 
expressed  in  this  work  so  frequently  in  our  observations  of  adults, 
both  normal  and  abnormal,  that  it  is  a great  satisfaction  to  see  a 
work  of  this  sort,  coming  from  a reliable  worker  dealing  with  these 
conditions  in  their  incipiency,  studied  conscientiously  and  thor- 
oughly, with  the  presentation  of  concrete  cases,  so  that  he  who 
runs  may  read  and  see  and  judge  for  himself  and  be  convinced, 
if  he  has  doubted  before. 

This  work  tells  us  of  educational  and  vocational  maladjust- 
ments resulting  in  children  who  have  peculiarities  which  require 
special  consideration  but  which  are  receiving  practically  no 
attention  with  our  present  methods  of  child  training. 

This  book  deals  not  with  the  out-and-out  feebleminded,  but 
with  the  individual  with  special  defect  and  the  subnormal  with 
special  ability. 


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283 


In  the  chapter  on  methods  of  diagnosis  it  is  shown  that  the 
■ordinary  measuring  scales  of  intelligence,  as  they  are  called,  are 
insufficient  to  detect  these  cases,  but  there  is  needed  an  intensive 
study,  by  many  methods,  of  each  particular  case.  He  who  wishes 
to  hurry  and  come  to  a quick  conclusion  not  only  misses  these 
cases  but  is  unfit  to  do  this  important  work— and  how  many  are 
doing  this  sort  of  work  without  a highly  developed  conscience  and 
regard  for  the  welfare  and  future  of  the  individual  child  I will 
leave  to  the  good  imagination  of  the  reader. 

In  this  chapter  on  differential  diagnosis  the  many  conditions 
to  be  taken  into  consideration  and  excluded  are  taken  up. 

In  her  consideration  on  “some  present  educational  tendencies” 
Dr.  Bronner  again  brings  home  to  us  the  importance  of  educational 
diagnosis  and  its  relationship  to  the  future  success  or  failure  of  the 
individual,  especially  as  regards  vocational  problems,  and  em- 
phasizes the  need  for  the  study  and  understanding  of  success  or 
failure  in  school  work,  in  this  or  that  field. 

There  then  follow  chapters  devoted  to  particular  aspects  of 
the  problem,  with  illustrative  cases.  She  considers  special  defects 
in  number  work,  in  language  ability  (reading,  spelling,  and  spoken 
language),  in  separate  mental  processes  [memory,  inner  visual 
functions,  work  with  concrete  material,  perceptual  abilities,  the 
higher  mental  processes — mental  representation,  perceptions  of 
relationships,  and  mentions  other  possible  disabilities  (such  as 
attention,  artistic  endeavors,  imagination  and  inventive  abilities, 
and  learning  ability)]. 

There  is  a chapter  on  defects  in  mental  control,  which,  if  one 
wished,  one  could  discuss  at  great  length,  since  it  is  directly  related 
to  the  general  question  of  nervous  and  mental  instability. 

The  authoress  then  discusses  the  problem  of  special  abilities 
with  general  mental  subnormality,  mentioning  specifically,  with 
illustrative  case-histories,  special  ability  in  number  work,  for 
language,  for  rote  memory,  and  on  the  motor  side,  and  then  devotes 
some  remarks  to  borderline  cases. 

The  chapter  on  general  conclusions  is  followed  by  an  appendix 
giving  the  records  of  the  psychological  examination  of  each  case 
cited  in  the  volume. 

Dr.  Bronner  rightly  calls  attention  to  the  fact  apparent  to 
many  of  us  that  the  present  tendency  in  mental  and  educational 
diagnosis  is  to  lay  stress  upon  defects  and  disabilities  only,  to  grade 
the  child  down  rather  than  up.  There  is  neglect,  to  a great  extent, 
to  search  for  special  gifts  or  unusual  capacities. 

In  other  words  we  must  know  the  reasons  for  success  or 
failure.  And  where  there  is  failure,  we  should  endeavor  to  learn 
how  success  in  one  direction  or  another  may  be  brought  about. 
This  means  work — conscientious,  sincere,  fairminded,  earnest 
work.  No  helter-skelter,  hurry-up  method  should  be  followed  or 
tolerated  in  these  cases.  It  means  that  we  should  give  the  child 


284 


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a square  deal — not  only  in  conditions  of  birth  and  health  physical- 
ly, but  in  our  educational  diagnosis  of  him,  our  starting  him  on 
the  right  course  in  life,  in  vocational  problems. 

Those  of  us  who  see  this  thing  in  a broad  light,  have  long 
realized  the  importance  of  this  very  problem  in  the  etiology  of 
certain  cases  of  delinquency  (crime),  alcoholism,  psychopathic 
states,  relative  degrees  of  failure  and  maladaptation  in  life. 

This  work  is  a definite,  concrete  presentation  of  a general 
problem  about  which  we  have  thought  and  talked  much  but  about 
which  little  has  been  done  up  to  the  present. 

As  such,  it  cannot  be  ignored  by  any  who  have  the  interest  of 
the  child  at  heart,  by  those  who  are  interested  in  any  of  the  many 
ramifications  and  broadening  fields  of  the  social  sciences. 

One  may  confidently  bespeak  for  this  volume  a wide  reading, 
as  a deserved  tribute  to  the  pioneer  work  of  a directly  practical, 
concrete  sort. 

This  work  can  be  looked  upon  as  a direct  challenge  and  warn- 
ing to  those  who  believe  that  by  the  Binet  scale  or  some  other 
single  method  of  measuring  intelligence  they  are  doing  all  they 
ought  to  do  in  the  study  of  the  mentality  and  educational  and 
vocational  possibilities  of  the  child. 

It  is  also  a warning  to  those  ultra-eugenists  who  are  in  the 
habit  of  saying  “Away  to  an  institution  with  the  child,”  advocat- 
ing permanent  segregation  and  custodial  care,  with  other  methods 
so  well  known  but  inapplicable  in  these  cases. 

And  the  moral?  Look  before  you  leap.  Don’t  jump  to 
conclusions,  especially  when  the  future  of  another  is  in  the  balance 
and  is  in  the  palm  of  your  hand,  so  to  speak.  It  is  becoming  a 
question,  too,  whether  the  opinion  of  a single  individual  should  be 
followed  in  many  of  these  cases,  and  whether  one  should  not  be 
checked  up  by  the  other  fellow — by  a fellow  worker.  Here,  too, 
I may  refer  to  the  suggestions  of  Yerkes  as  given  in  his  brief  paper 
entitled  “How  May  We  Discover  the  Children  Who  Need  Special 
Care?”  in  the  April,  1917  number  of  Mental  Hygiene. 

Meyer  Solomon. 

man’s  unconscious  conflict.  By  Wilfred  Lay,  Ph.  D. 
New  York:  Dodd,  Mead  & Company,  1917.  $1.50  net.  Pp.  318. 

The  subtitle  of  this  work  refers  to  it  as  “a  popular  exposition 
of  psychoanalysis.” 

The  plan  of  the  work  is,  in  brief,  as  follows : There  is  an  intro- 
duction, followed  by  chapters  entitled  “the  unknown  element  in 
action;”  “the  Oedipus  myth;”  “the  foreconscious;”  “the  uncon- 
scious (descriptive)  ” which  deals  with  ten  aspects  labelled  complete 
retentiveness,  repression,  independent  vitality,  symbolism,  the 
censor,  sublimation,  introversion,  pleasure-pain  versus  reality, 
regression,  and  universality  of  manifestation;  “the  unconscious 


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285 


(dynamic),”  with  seven  sub-headings  entitled  craving  or  reality?, 
where  do  thoughts  come  from?,  resistances,  conflicts,  complexes, 
phobias,  and  our  mental  attitude;  “the  individual  psyche;” 
“dreams;”  “two  kinds  of  thinking;”  “everyday  life,”  “psycho- 
therapy,” dealing  with  the  moral  struggle,  reasoning  by  analogy, 
psychic  gravitation  and  the  transference;  “educational  applica- 
tions,” with  divisions  devoted  to  the  object  of  mental  activity, 
the  father-image,  the  superiority  feeling,  “he  irritates  me,”  mem- 
ory work,  abstract  thinking,  and  hate,  anger,  and  love;  with  a 
final  chapter  on  “conclusions.” 

The  writer  has  done  well  in  his  efforts  to  present  a popular 
exposition  of  psychoanalysis.  Of  course,  many  of  us  may  question 
the  propriety  of  presenting  a popular  exposition  of  views  still 
under  discussion,  most  of  them  sub  judice,  many  of  them  disproven. 
But,  however,  that  is  beside  the  question. 

Lay  has  combined  the  views  of  Freud  and  his  followers,  in- 
cluding Jung,  and  to  a certain  extent  even  Adler,  and  has  given 
the  public,  in  so  far  as  it  is  in  search  of  these  views,  a brief,  com- 
pact, well-written,  correct,  plainly-put  but  carefully  and  judiciously 
presented  summary  which  has  culled  the  literature  of  psycho- 
analysis for  the  most  important  conclusions  which  have  been 
arrived  at  by  Freud  and  his  followers. 

Naturally,  under  the  circumstances,  Lay  offers  nothing  more 
than  a second-hand,  orthodox  presentation  of  these  views.  But 
he  tells  the  story  well,  and  the  average  reader  will  find  it  enter- 
taining and  suggestive  enough  to  probe  more  deeply  into  psycho- 
analysis and  the  so-called  deeper  psychology. 

In  this,  then,  the  writer  has  accomplished  his  purpose  decided- 
ly satisfactorily,  from  his  standpoint,  to  be  sure. 

As  a result,  no  really  critical  presentation  of  any  of  the  views 
compiled  is  in  the  slightest  degree  attempted.  All  is  presented 
as  if  it  were  the  positive,  untarnished,  absolutely  proven  and 
thoroughly  agreed  upon  truth — which,  as  we  all  know,  Freudians, 
Jungians,  Adlerians  and  others,  is  not  so,  by  any  means. 

Consequently  one  finds  throughout  the  work  a carelessness  of 
statement  of  fact,  with  an  uncalled-for  cocksureness  of  statement, 
with  a tendency  to  extremism  and  exaggeration.  This,  however, 
can  be  forgiven  or  rather  understood,  if  we  take  into  consideration 
what  the  objects  or  motives  of  Lay  were  in  writing  this  book. 

In  much  that  he  has  written,  too,  it  seems  that  the  writer  has 
had  no  direct  experience.  Not  being  a medical  man,  much  of 
what  he  says  under  psychotherapy,  for  instance,  with  especial 
relation  to  physical  illnesses  supposed  to  be  due  to  psychic  factors, 
is  but  hearsay  or  repetition  of  statements  made  by  others,  who, 
regardless  of  their  high  standing,  may  have  been  entirely  wrong 
in  their  conclusions  or  interpretations. 

Consider,  if  you  will,  the  following  statement  made  by  Lay  on 
page  259:  “It  is  quite  reasonable,  too,  to  suppose  that  many  dis- 


286 


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eases  are  compensations  for  certain  circumstances  of  the  environ- 
ment of  the  sufferers.  Napoleon,  whose  ambition  might  justify 
one  in  calling  him  the  personification  of  assimilative  appetite,  dies 
of  cancer  of  the  stomach,  a childless  married  woman  dies  of  cancer 
of  the  breast,  some  men  drink  life  to  the  lees  and  perish  prematurely 
of  uraemic  poisoning.”  Well,  now,  one  is  impelled  to  ask,  what 
about  it?  Is  not  this  symbolism  with  a vengeance?  Is  not  this 
going  the  very  limit,  and  so  far  beyond  it  that  one  has  reached 
the  land  of  absurd  dreams  and  the  loosest  thinking,  when  one 
permit  one’s  self  to  reason  in  this  unrestrained  fashion?  Where 
will  one  stop,  once  one  permits  one’s  self  to  indulge  in  such  loose 
thinking?  This  is  getting  as  bad  as  Christian  Science  in  its  ab- 
surd claims  of  the  supernatural  influence  of  ideational  processes 
on  the  bodily  activities. 

Let  psychopathologists  not  go  to  the  extreme  of  attributing 
to  psychic  processes,  least  of  all  to  ideas,  all  sorts  of  physical 
ailments,  without  a close  study  of  the  facts,  of  the  modus  operandi. 
Prove  your  case.  Don’t  jump  to  conclusions  and  make  baseless, 
unsupported,  even  though  sensational  and  astounding  assertions. 

Meyer  Solomon. 

philistine  and  genius.  By  Boris  Sidis,  A.  M.,  Ph.  D., 
M.  D.,  Medical  Director,  Sidis  Institute,  Portsmouth,  N.  H . Boston. 
Richard  G.  Badger,  1917.  Pp.  122.  $1.00  net. 

This  is  “a  revised  third  edition  with  an  additional  preface  on 
current  events  and  an  essay  on  Precocity  in  Children.” 

In  the  preface  Sidis  calls  attention  to  the  horrors  of  the  great 
war  and  some  of  the  errors  in  the  modern  social  organization.  He 
deprecates  the  training  of  children  by  fear,  submission  and  blind 
obedience  to  so-called  superiors  with  the  exploitation  and  develop- 
ment of  undesirable,  handicapping  traits,  especially  too  much 
cultivation  of  the  herd  tendency,  with  suggestion  and  imitation  to 
the  fore,  while  expansion  of  the  personality  and  self-knowledge 
and  freedom  of  expression  of  hidden  abilities  and  powers  are 
stifled  into  nothingness.  “The  progress  of  humanity  is  from  brute 
to  man,  from  Philistine  to  genius.” 

He  calls  attention  to  some  of  the  glaring  vices  and  incon- 
gruities and  superficialities  of  modern  civilization  and  industrial 
life,  with  its  consciously  purposive  application  of  Darwinian 
principles  to  human  life-activities  in  all  their  brutality.  “The 
true  education  of  life  is  the  recognition  of  evil  wherever  it  is  met,” 
for,  after  all,  “The  principle  of  recognition  of  evil  under  all  its 
guises  is  at  the  basis  of  the  true  education  of  man.” 

He  indicates  some  of  the  patent  faults  of  our  modern  educa- 
tional system. 

“There  is  no  place  for  genius  in  our  schools.  Originality  is 
suppressed.  Individuality  is  crushed.  Mediocrity  is  at  a premi- 


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287 


“Awaken  in  early  childhood  the  critical  spirit  of  man;  awaken 
early  in  the  child’s  life,  love  of  knowledge,  love  of  truth,  of  art  and 
literature  for  their  own  sake,  and  you  arouse  man’s  genius.” 

“The  cultivation  of  the  power  of  habit-disintegration  is  what 
constitutes  the  proper  education  of  man’s  genius.”  He  insists  that 
■we  should  cultivate  variability,  for  this  permits  one  to  have  re- 
course to  the  potential,  hidden,  stored-up,  dormant,  unused,  sub- 
conscious, reserve  energies  latent  in  all  of  us. 

His  suggestion  is  as  follows:  Excepting  the  children  backward 
in  development  because  of  congenital  or  some  overlooked  patho- 
logical condition  perhaps  easily  remedied  by  proper  treatment, 
Sidis  insists  that  in  the  large  majority  of  children  the  beginning  of 
education  should  be  between  the  second  and  third  years  of  life, 
and  from  the  very  beginning  the  child’s  energies  and  interests 
should  be  directed  to  intellectual  activity  and  love  of  knowledge 
rather  than  the  usual  nursery  games  and  physical  exercises.  Our 
schools  and  colleges  are  training  their  students  in  the  art  of  money- 
getting and  the  like  rather  than  stirring  up  in  them  a real  love  for 
knowledge. 

“We  do  not  appreciate  the  genius  harbored  in  the  average 
child,  and  let  it  lie  fallow.” 

That  we  have  up  to  date  only  scratched  the  surface  of  man’s 
possibilities,  and  scratched  it  too  often  in  the  wrong  place,  no  one 
who  has  seriously  reflected  upon  this  can  deny.  Hence  we  must 
whole-heartedly  agree  with  Sidis  when  he  asserts:  “We  can  develop 
into  a great  race  by  the  proper  education  of  man’s  genius.” 

Every  psychopathologist,  psychiatrist  and  educator  must 
agree  when  the  author  warns  us  to  guard  the  child  against  all  evil 
fears,  superstitions,  prejudices,  and  credulity,  in  order  to  prevent 
nervous  and  mental  diseases  and  their  allies. 

So  convinced  is  Sidis  that  the  control  of  mental  and  moral 
life  should  be  in  the  hands  of  the  medical  psychopathologist  that 
he  ventures  to  predict  that  the  medical  man  will  in  the  future  as- 
sume the  supervision  of  the  education  of  the  nation. 

In  the  appendix,  he  calls  attention,  among  other  points,  to 
the  groundlessness  of  the  fear  of  the  results  of  the  application  of 
the  method  he  advocates,  for  it  shows  that  we  are  but  afraid  of 
genius,  “especially  when  it  is  manifested  as  ‘precocity  in  child- 
hood.’ ” 

Throughout  the  volume  Sidis  writes  with  terrific  force  and 
power,  and  his  intensity,  his  sincerity,  and  his  whole-souled  devo- 
tion to  the  cause  to  which  he  has  given  himself  in  this  book  shines 
through  on  every  page. 

Here,  too,  as  elsewhere,  he  shows  a clarity  of  thinking,  a 
directness  and  unerring  aim  in  expression,  and  a keen  understand- 
ing of  that  which  he  has  undertaken  to  discuss. 

I heartily  and  earnestly  recommend  the  work  to  the  readers 
of  the  Journal  of  Abnormal  Psychology. 


Meyer  Solomon. 


BOOKS  RECEIVED 


mental  adjustments.  By  Frederic  Lyman  Wells.  D.  Apple- 
ton  & Co.  Pp.  XIII  plus  331.  $2.50  net. 

contributions  to  psycho-analysis.  By  Dr.  S.  Ferenczi. 
Translated  by  Dr.  Ernest  Jones.  R.  G.  Badger.  Pp.  288.  $3.00. 

sex  worship  and  symbolism  of  primitive  races.  By  San- 
ger Brown  IF  R.  G.  Badger.  Pp.  145.  $3.00. 

A POINT  SCALE  FOR  MEASURING  MENTAL  ABILITY.  By  Robert 

M.  Yerkes , James  W.  Bridges , Rose  S.  Hardwick.  Warwick  & 
York.  Pp.  218.  $1.25. 

the  animal  mind.  By  Margaret  Floy  Washburn.  The  Mac- 
millan Co.  Pp.  XII  plus  386.  $1.90. 

the  mastery’  of  nervousness.  By  Robert  S.  Carroll.  The 
Macmillan  Co.  Pp.  346.  $2.00. 

AN  INTRODUCTION  TO  THE  PHYSIOLOGY  AND  PSYCHOLOGY  OF 

sex.  By  S.  Herbert,  A.  & C.  Black,  Ltd.  (The  Macmillan  Co.) 
Pp.  XII  plus  136.  $1.35. 

science  and  learning  in  France.  An  Appreciation  by  Amer- 
ican Scholars.  Northwestern  University  Press.  Pp.  XXXVIII 
plus  453. 

AN  ANALYSIS  OF  THE  LEARNING  PROCESS  IN  THE  SNAIL,  PHYSA 

gyrina  say.  By  Elizabeth  Lockwood  Thompson.  Behavior  Mono- 
graph Series.  Henry  Holt  & Co.  Pp.  Ill  plus  97.  $1.25. 

THE  EFFECT  OF  LENGTH  OF  BLIND  ALLEYS  ON  MAZE  LEARNING  : 

An  Experiment  on  Twenty-Four  White  Rats.  By  Joseph  Peterson 
Behavior  Monograph  Series.  Henry  Holt  & Co.  Pp.  Ill  plus  53 
75c- 


288 


THE  JOURNAL  OF 
ABNORMAL  PSYCHOLOGY 


VOL.  XII  DECEMBER,  1917  NUMBER  5 

ORIGINAL  ARTICLES 

COCON SCIOUS  IMAGES1 

BY  MORTON  PRINCE 

THE.  phenomena  which  I am  about  to  describe  are 
important  because,  if  the  evidence  upon  which 
they  depend  is  accepted  as  veridical,  they  afford 
direct  evidence  of  specific  subconscious  processes 
occurring  under  certain  conditions.  Even  the  most  ardent 
of  clinical  psychologists  must  admit  that  the  subconscious 
processes  which  they  postulate  to  explain  their  clinical 
phenomena  are  based  on  indirect  or  circumstantial  evidence; 
that  is  to  say,  the  postulate  of  a subconscious  process  is 
inferred  from  the  behavior  of  the  phenomena  and  the  logical 
relation  which  appears  to  exist  between  them  and  certain 
antecedent  experiences,  that  give  justifiable  grounds  for  the 
inference  of  a causal  relationship.  This  causal  relation  re- 
quires the  assumption  of  a subconscious  process  acting  as 
an  intermediary  between  the  conserved  antecedent  experi- 
ence and  the  present  observed  phenomena.  In  other  words, 
all  takes  place  as  if  there  were  this  subconscious  process. 

Now,  for  the  subconscious  phenomena  about  to  be  describ- 
ed the  evidence  is  direct.  I have  said  that  the  acceptation 
of  the  phenomena  depends  upon  the  acceptation  of  the 
evidence  as  trustworthy.  If  this  be  not  accepted,  the 
phenomena  are  valueless.  The  evidence  is  that  of  memory 

1 Presented  at  the  Eighth  Annual  Meeting  of  the  American  Esj^chopatholog- 
ical  Association,  Boston,  May  24,  1917. 

Copyright  iqiS,  by  Richard  G.  Badger.  All  Rights  Reserved. 

289 


290 


Coconscious  Images 


derived  from  introspection.  It  is  the  same  kind  of  evidence 
that  must  necessarily  be  used  and  accepted  in  all  psycho- 
logical investigations  into  the  content  of  consciousness.  It 
would  seem  that  if  this  kind  of  evidence  is  accepted,  as  it  is, 
in  one  class  of  psychological  investigations,  there  is  no  justi- 
fication in  refusing  it  in  another.  But  of  course  in  every 
investigation  employing  this  method,  everything  depends 
upon  the  accuracy  of  the  powers  of  introspection  and  trust- 
worthiness of  the  subject.  I have  observed  these  phenom- 
ena in  three  cases  only — two  of  my  own  and  one  of  Dr. 
Waterman’s,  who  kindly  permitted  me  to  observe  his  case 
with  him.  My  own  two  cases  were  studied  over  a long 
period  of  time,  and  therefore  I had  an  opportunity  to  weigh 
carefully  the  introspective  capacity  of  the  subjects,  their 
introspective  memories,  and  their  trustworthiness.  I have 
not  the  slightest  doubt  regarding  any  of  these  points.  Dr. 
Waterman  has  the  same  confidence.  Furthermore,  my  own 
cases  have  been  submitted  to  quite  a number  of  well-known 
competent  observers,  and  no  one  has  expressed  the  slightest 
doubt  regarding  their  veridical  nature. 

Regarding  the  significance  and  interpretation  of  the  phe- 
nomena I am  not  prepared  to  express  definite  conclusions. 
They  permit,  however,  of  provisional  theories  which  I will 
offer  in  the  proper  place. 

Description  of  the  Phenomena 

The  phenomena  consist  of  coconscious  “pictures,”  for 
the  most  part  visualizations,  sometimes  auditory  “percep- 
tions,” which  occur  outside  the  field  of  awareness.  I say 
“coconscious”  and  “outside  the  field  of  awareness”  because 
the  subjects  in  their  normal  waking  state  are  entirely  un- 
aware of  them.  By  no  effort  of  mental  concentration  or 
introspection  can  they  possibly  bring  back  memories  of  such 
pictures  ever  having  entered  the  field  of  consciousness,  nor 
are  they  aware  of  them  at  the  moment  of  occurrence.  There 
is  no  immediate  awareness  of  them,  and  it  is  only  by  retro- 
spection under  the  conditions  of  certain  methods  of  investi- 
gation that  memories  of  these  coconscious  pictures  can  be 
recovered. 


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291 


The  method  employed  was  that  of  retrospection  in  hypno- 
sis. When  the  subjects  were  hypnotized  and  thereby  put 
into  a condition  where,  as  so  commonly  happens,  the  capacity 
for  synthesization  is  enhanced,  memories  of  coconscious 
phenomena  which  it  was  claimed  had  never  entered  the  field 
of  awareness  were  obtained.  These  memories  were  very 
precise,  definite  and  realistic.  There  never  was  any  doubt 
about  them  as  memories,  nor  any  doubt  about  them  as 
previous  realities,  that  is  to  say,  real  psychical  occurrences. 
They  were  always  described  as  vivid  pictures  (or  auditory 
sounds,  music,  etc.)  varying  in  character  from  a single 
* picture,  as  of  a face  or  other  object,  to  a succession  of  pictures, 
like  motion-pictures  representing  the  action  of  a scene. 
They  were  in  other  words  similar  to  the  visualizations  (be- 
longing to  perceptions)  which  occur  normally  in  the  course 
of  conscious  thought,  as  when  one  thinks  of  a person  or 
place  or  scene,  only  they  were  more  vivid  and  when  cinema- 
tographic more  complex,  and  did  not  appear  within  the 
conscious  content  of  awareness.  Furthermore,  these  visuali- 
zations or  pictures  were  not  integral  elements  0]  the  conscious 
stream  of  thought  ( perceptions ),  hut  in  their  content  pertained 
to  matter  of  which  the  subject  was  not  consciously  thinking  at 
the  moment.  The  matter  generally,  if  not  always,  was  related 
to  antecedent  mental  experiences  (thoughts)  with  or  with- 
out secondary  elaboration. 

The  conditions  under  which  these  phenomena  were  ob- 
served were  various;  for  instance,  they  occurred  regularly 
during  the  course  of  suggested  post-hypnotic  acts,  often  as 
post-dream  phenomena,  and  as  phenomena  of  repressed 
thoughts,  etc.  They  will  be  classified  later  after  I have 
given  a few  examples  in  order  that  their  nature  may  be  more 
clearly  understood  at  the  outset.  For  this  purpose  I will 
take  a type  occurring,  perhaps,  under  the  simplest  condi- 
tions, namely,  suggested  post-hypnotic  phenomena. 

1.  Post-Hypnotic  Phenomena 

Observation  1 : The  suggestion  was  given  to  the  subject 
in  hypnosis  that  after  waking,  on  the  entrance  of  Dr.  Water- 
man into  the  room,  she  was  to  go  to  the  bookcase,  take  down 


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Coconscious  Images 


a book,  take  it  to  the  table  and  place  it  by  the  telephone 
instrument.  She  then  was  to  take  a cigarette  from  the  box 
and  put  it  in  her  mouth.  The  latter  suggestion  she  refused 
to  accept  saying  that  she  “would  not  do  it,”  that  “I  could 
not  make  her  do  it,”  etc.  Nevertheless  I insisted. 

This  suggestion,  after  waking,  was  accurately  carried 
out  up  to  the  point  of  putting  the  cigarette  in  her  mouth. 
Instead  of  doing  this  she  laughed  and,  after  some  hesitation, 
offered  a cigarette  to  me  and  to  Dr.  Waterman. 

The  subject  was  then  put  into  three  different  hypnotic 
states  and  the  following  memories  elicited  of  what  occurred 
subconsciously  during  the  suggested  post-hypnotic  action. 
I will  give  substantially  the  exact  words  used  in  one  of  these 
states.  (In  this  state,  not  in  the  others,  the  subject  speaks 
of  herself  in  the  third  person,  as  “C.  ”) 

“You  know  after  you  woke  her  up  and  you  went  into  the 
other  room  to  summon  Dr.  Waterman,  there  began  to  be  pictures 
in  the  subconscious  portion  of  her  mind.  There  was  a picture 
of  the  bookcase,  then  one  of  Dr.  P. — very  bright,  much  brighter 
than  that  of  the  bookcase — and  then  there  was  a picture  of  a 
woman  walking  across  the  room,  taking  a book  out  of  the  bookcase 
and  then  coming  back  and  putting  it  down  by  the  telephone. 
(The  picture  was  not  of  the  subject.)  She  was  in  black,  tall,  had 
gray  hair.  A picture  of  you  alternated  with  all  the  pictures. 
There  was  an  ornate  gold  frame,2  very  bright,  about  your  picture. 
These  pictures  first  came  after  awaking,  before  getting  up  from 
the  sofa,  (perhaps  a minute).  C did  not  see  them  but  she  thought 
of  a bookcase  alone  and  nothing  more.  Afterwards  she  got  up 
and  as  she  proceeded  to  carry  out  the  act  the  pictures  still  kept 
coming  and  going,  subconsciously.  When  she  took  down  the 
book  a picture  of  a woman  taking  down  a book  came  into  Cl' s3 
mind  and  each  act  was  accompanied  by  a picture  corresponding 
to  the  act  and  each  picture  alternated  with  a picture  of  you.  After 
she  had  laid  the  book  down  she  turned  to  the  table  where  the 
cigarettes  were  when  there  came  a very  bright  picture  of  a ballet 
or  chorus  girl.  The  girl  had  short  red  skirts  of  tulle  and  she  was 

2 This  gold  frame  frequently  appeared  under  certain  conditions  and  seemed 
to  have  a symbolic  meaning  in  that  it  stood  for  my  authority,  suggestions,  thera- 
peutic assurances,  advice,  etc.  This  symbolism  was  a perseveration  of  commands, 
or  assurances  that  all  was  well,  etc.;  i.  e.  actual  therapeutic  suggestions  and  advice 
given  to  solve  her  problems  and  resolve  her  mental  conflicts. 

2 C2  was  an  arbitrarily  agreed  upon  term  to  designate,  for  short,  that  sub- 
conscious portion  of  the  mind  in  which  the  pictures,  which  did  not  appear  in  aware- 
ness, occurred. 


Morton  Prince 


293 


sitting  at  a table  with  her  feet  crossed.  A three  cornered  hat  was 
on  her  head  and  she  was  smoking  a cigarette.  She  looked  very  gay. 
This  was  when  C picked  up  the  box  of  cigarettes  and  as  she  did  so 
there  came  the  thought  that  she  would  put  a cigarette  in  her 
mouth  and  then  she  felt  shocked  at  the  idea.  It  was  with  a picture 
of  the  ballet  girl  that  the  thought  came  to  put  a cigarette  in  her 
mouth  and  then  she  felt  shocked  at  the  idea  of  doing  such  a thing. 
No  pictures  came  into  her  conscious  mind,  only  two  thoughts,  one 
of  the  bookcase,  the  other  of  putting  a cigarette  in  her  mouth. 
The  pictures  were  subconscious  (C2).” 

The  picture  of  the  ballet  girl  had  an  interesting  history. 
It  transpired  that  this  picture  was  a replica  of  a real  picture 
which  she  had  seen  elsewhere  and  which  previously  had 
brought  to  her  mind,  much  to  her  disapproval,  the  kind  of 
people  who  smoke  cigarettes.  It  had  made  an  impression  of 
aversion,  for  it  symbolized  her  punctilious  ideas  as  to  smok- 
ing cigarettes.  This  general  aversion,  without  any  specific 
memory  of  the  picture,  was  why  she  had  been  consciously 
unwilling  to  accept  the  suggestion  to  smoke  them.  But 
smoking  cigarettes  had  been  actually  associated  in  her  mind 
with  the  ballet  girl  type  of  person,  and  apparently  this  strong- 
ly associated  idea,  symbolized  in  the  form  of  a previously 
experienced  picture,  arose  subconsciously  at  the  moment 
when  the  suggested  act  was  to  be  performed.  When  she 
felt  shocked  that  she  should  have  the  idea  of  smoking  a 
cigarette  this  subconscious  picture  of  a ballet  girl  appeared. 

Obs.  2:  The  suggestion  was  given  in  hypnosis  that 

the  subject  was  to  bring  to  me  the  next  day  a manuscript. 
The  authorship  of  this  manuscript  was  symbolized  by  the 
letter  A for  reasons  not  necessary  to  go  into.  This  sug- 
gestion was  carried  out,  the  manuscript  being  brought  in  her 
muff  and  handed  to  me  without  the  subject  afterwards  being 
aware  of  what  she  had  done.  That  is  to  say,  she  had  no 
knowledge  of  the  suggestion  or  of  the  fact  of  having  carried 
it  out. 

The  coconscious  events  were  afterwards  described  in  two 
different  hypnotic  states  as  follows,  the  language  of  each 
description  of  course  being  somewhat  different: 

After  the  subject  was  awakened  from  hypnosis,  on  her  way 
home,  “there  kept  coming  and  going  coconscious  visual  images  of 


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Coconscious  Images 


the  letter  A (rather  vague  and  indistinct)  and  of  the  letters 
MS.  These  floated  in  and  out,  alternating  with  a bright  picture 
of  you,  much  brighter  than  the  others.  Then,  while  she  was  eat- 
ing her  dinner  there  came  a picture  of  her  desk  where  she  keeps 
all  her  papers — all  the  copies  of  all  that  she  has  done  for  you. 
The  picture  of  the  desk  was  brighter  than  that  of  A.  The 
lower  drawer  was  open.  There  were  some  hands  searching  all 
through  the  papers  and  taking  out  some  papers  and  rolling  them 
and  putting  an  elastic  around  them.  There  appeared  over  and 
over  \isual  images  of  hands,  desk,  manuscript,  hands,  desk, — 
then  there  came  a picture  of  her  muff  and  the  hands  putting  the 
roll  of  manuscript  in  the  muff,  then  again  a picture  of  you.  These 
all  went  through  her  mind  [coconsciously].  First  A,  then 
picture  of  you,  then  MS,  then  picture  of  you,  then  desk  and- 
hands  getting  papers,  then  you,  then  muff,  then  you,  then  hands 
putting  papers  in  muff,  then  you,  then  roll  of  papers  in  muff, 
then  you,  then  there  was  a picture  of  hands  giving  the  roll  to  you. 
These  alternated  over  and  over. 

Of  the  pictures,  that  of  you  was  all  that  was  in  C’s  conscious- 
ness. She  didn’t  think  about  it  but  it  floated  into  her  mind.” 

(Note  that  in  this  observation  one  of  the  pictures,  that 
of  me,  emerged  into  consciousness.  This,  as  we  shall  see 
later  sometimes  happens,  and  then  it  may  appear  as  an  hallu- 
cination.) 

The  mental  condition  during  the  actual  carrying  out  of 
the  post-hypnotic  act  was  described  as  follows: 

After  she  had  gone  upstairs  and  when  she  was  going  to  bed 
she  went  to  the  drawer  to  take  her  diary  out  to  write  in  it  and  she 
burrowed  down  under  all  those  papers  and  took  out  that  manu- 
script and  rolled  it  up  and  put  an  elastic  around  it  and  put  it  in  her 
muff,  but  she. did  not  know  she  had  done  it.  She  did  it  in  a per- 
fectly absent-minded  way.  She  was  thinking  of  her  conversation 
with  you  before  she  left.  She  was  entirely  unconscious  of  what 
she  was  doing.  With  each  act  as  above  described  a correspond- 
ing picture  appeared  in  C2.  For  example:  picture  of  open  drawer 
— she  opened  the  drawer;  hands  picking  up  manuscript — she 
picked  up  manuscript,  etc. 

That  all  happened  last  night.  This  morning  she  came  in 
with  the  manuscript  in  her  muff.  She  had  her  finger  in  the  roll 
all  the  way  in  but  she  did  not  know  it.  She  had  it  in  her  hand 
when  she  took  her  things  off,  came  in  here  and  gave  it  to  you. 
When  she  gave  it  to  you  the  pictures  of  you  and  the  hands  were 
very  bright  in  C2  and  I think  also  in  C’s  mind,  in  an  unconscious 
way.  She  handed  it  to  you  in  an  absent-minded  way.  That  is, 
she  did  not  know  what  she  was  doing. 


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295 


Note  the  fact  that  these  coconscious  pictures  began  to 
come  and  go  shortly  after  the  suggestion  was  given  in  hypno- 
sis and  for  a long  time  before  the  suggestion  was  to  be  carried 
out,  showing  that  some  sort  of  a subconscious  process 
energized  by  the  suggestion  was  in  activity  and  that  this 
process  was  apparently  the  same  process  that  was  going  on 
during  the  carrying  out  of  the  suggested  act,  for  the  pictures 
were  the  same  up  to  the  fulfillment.  Whether  this  was  a 
correlated  process  or  a causal  process  the  facts  do  not  abso- 
lutely establish  although  the  natural  inference  is  that  it 
was  a causal  one. 

These  same  phenomena  were  frequently  observed, 
when  inquired  into,  following  suggestions  given  for  thera- 
peutic purposes.  The  resulting  phenomena  of  course  be- 
long to  the  same  class,  namely,  suggested  post-hypnotic 
phenomena. 

Obs.  3 : On  one  occasion,  for  instance,  I suggested  to  the  sub- 
ject in  hypnosis  that  she  would  be  “as  hungry  as  a pig;”  I also 
gave  the  suggestion  of  “sleep”  to  relieve  the  insomnia  of  which 
she  had  complained.  In  giving  the  suggestion  “sleep”  I had 
described  how  sleepy  she  would  be  when  she  went  to  bed — that 
her  head  would  droop,  droop,  etc.  It  transpired  that  when  I said 
this  she  thought  of  a child  and  it  reminded  her  of  a mother  putting 
a child  to  sleep.  Now  later  after  waking  there  were  coconscious 
pictures  of  some  little  pigs  scrambling  over  each  other  to  eat  from 
a trough.  This  was  followed  by  a picture  of  me  in  a frame,  but 
not  bright  as  it  had  been  before.  This  again  was  followed  by  a 
picture  of  a woman  trying  to  wake  a child  who  was  very  sleepy. 
The  woman  could  not  wake  her.  She  took  the  child  by  the 
shoulders  and  the  child’s  head  fell  back  from  one  side  to  the  other 
as  when  overcome  by  sleep.  These  pictures  of  the  sleeping  child 
were  faint  and  shadowy.  With  pictures  of  the  pigs  the  subject 
felt  that  she  must  eat  something  and  with  those  of  the  sleeping 
child  she  felt  sleepy,  and  although  she  did  not  feel  hungry  she 
drank  some  milk,  and  in  spite  of  a certain  sadness  and  depression 
she  slept  fairly  well. 

This  affective  state  could  be  correlated  with  other 
pictures  occurring  at  this  time,  alternating  or  coincident. 
This  correlation  will  be  described  later  in  connection  with 
affective  states. 

It  should  be  noted  that  the  pictures  of  the  sleeping  child 


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Coconscions  Images 


were  not  simply  reproductive  representations  of  the  thought 
experienced  at  the  time  of  the  suggestion  but  were  distinct 
coconscious  elaborations  of  the  same  and  therefore  fabrica- 
tions. The  same  probably  is  true  of  the  “little  pigs.” 

The  above  examples  make  the  character  of  the  phe- 
nomena clear.  Taking  the  phenomena  as  a whole  they  may 
be  grouped  for  convenience  of  study  in  the  following  types: 
Those  occurring  as 

1.  Phenomena  of  post-hypnotic  suggested  acts. 

2.  After-phenomena  of  dreams. 

3.  After-phenomena  of  repressed  thoughts. 

4.  Phenomena  of  moods,  particularly  depressed  or 

exalted  states. 

5.  Symbolisms. 

6.  Phenomena  in  the  mechanism  of  hallucinations. 

7.  Phenomena  of  perseveration  of  previous  emotional 

complexes. 

This  classification  is  not  exclusive,  inasmuch  as  the 
characteristics  of  two  or  more  types  may  be  present  in  any 
given  phenomenon.  For  example,  as  after-phenomena  of 
dreams  they  may  also  represent  repressed  thoughts  giving 
rise  to  and  occurring  in  the  dreams;  and  as  phenomena  of 
moods  they  may  exhibit  the  characteristics  of  any  of  the 
other  conditions. 

The  behavior  of  the  phenomena  is  comprehensible  only 
on  the  theory  that  they  are  not  the  whole  subconscious 
process,  but  are  coconscious  elements  in  a more  elaborate 
underlying  process  which  cannot  be  brought  to  consciousness 
as  a memory,  as  can  the  pictures.  For  the  most  part  the 
pictures  and  the  inferred  underlying  processes  can  be  logically 
interpreted  as  revivals  or  perseverations,  with  or  without 
secondary  elaboration,  of  antecedent  thoughts  (experiences). 

Sometimes  the  coconscious  phenomenon  could  be  cor- 
related, 

(a)  With  conscious  affects:  that  is  to  say,  the  affective 
state  of  exaltation  or  depression  (mood)  coloring  con- 
sciousness bore  no  relation  to  the  conscious  thoughts  of 
the  subject,  but  corresponded  to  these  coconscious  phe- 
nomena of  which  the  subject  was  unaware. 


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297 


(b)  With  somatic  phenomena  in  an  apparently  causal 
relation:  as  when  coconscious  images  of  movements  of  the 
hands  or  feet  were  accompanied  by  such  movements. 

(c)  With  conscious  thoughts;  as  when,  following  or  coinci- 
dent with  the  images,  thoughts  pertaining  to  the  objects 
pictured  entered  the  subject’s  mind. 

(d)  With  antecedent  thoughts  of  which  they  were  pictorial 
representations,  sometimes  in  symbolic  and  allegorical 
form. 

(e)  With  hallucinations  which  were  simply  the  emergence 
into  awareness  of  the  coconscious  images. 

In  giving  the  records  of  further  observations  the  above 
classification  of  types  will  not  be  strictly  followed  in  view  of 
the  fact  that,  as  already  stated,  any  given  phenomenon  may 
exhibit  the  characteristics  of  several  types. 

2.  After-Phenomena  of  Dreams 

Coconscious  pictures  which  had  been  elements  of  pre- 
vious dreams  frequently  occurred.  Sometimes  they  were 
accompanied  by  somatic  phenomena  which  again  were  ele- 
ments in  the  dreams.  Frequently  repressed  thoughts  which 
appeared  in  the  dreams  also  appeared  in  the  pictures.  The 
following  are  examples. 

1.  In  this  dream  she  was  at  the  entrance  of  a great  cave. 
Some  one,  a figure,  came  rushing  past  her  with  his  hand  over  his 
(or  her)  eyes.  This  figure  said  “Do  not  look!  You  will  be  blind- 
ed!” Suddenly  it  flashed  light  in  the  cave,  like  a flash  light 
picture  and  she  saw  a scene  there  enacted.  Then  everything 
became  black  as  if  she  were  blinded,  and  then  it  would  flash  and 
illuminate  the  cave  and  she  would  again  see  the  enactment  of  the 
scene.  This  happened  three  or  four  times  in  the  dream. 

Now  after  waking  pictures  began  coming  and  going 
coconsciously — of  the  cave,  and  of  the  objects  seen  there 
in  the  dream;  and  sometimes  coincidentally  with  the  occur- 
rence of  these  pictures,  of  which  of  course  she  was  not  aware, 
she  would  see  consciously,  i.  e.  be  aware  of,  a flash  of  light 
just  as  she  did  in  the  dream.  Then  it  was  as  if  again  she 
looked  into  a brilliantly  lighted  place  and  saw  there  some 


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horrible  object  (the  scene  in  the  dream,  although  she  did 
not  know  it  to  be  such).  It  may  be  added,  although  not 
germane  to  the  point,  that  at  first,  after  waking,  she  was 
unsteady  and  shaken  nervously,  but  after  a time  the  picture 
of  me  in  the  frame  began  to  come  coconsciously  and  alter- 
nate with  the  above  dream  pictures,  and  with  the  picture 
of  me  she  would  become  steadier  and  would  think  (guided 
by  past  experiences),  “It  is  only  a dream  probably.  I won’t 
allow  it  to  upset  me.  I will  be  just  as  calm  as  I can  and  it 
will  probably  be  all  right,”  etc.  When  this  dream  was  in- 
terpreted it  was  not  difficult  to  show  that  the  cave,  flashes 
of  light,  blindness,  etc.,  symbolized  pictorially  antecedent 
thoughts  that  she  had  had,  and  had  tried  to  repress. 

Such  phenomena  would  seem  to  compel  the  conclusion 
that  the  same  process  which  had  produced  the  dream  content 
continued  to  function  subconsciously  during  the  waking  state 
and  caused  the  coconscious  pictures  on  the  one  hand  and  the 
somatic  phenomena  on  the  other. 

It  should  be  noted  in  passing,  for  we  shall  see  a more 
striking  example  later,  that  some  of  the  coconscious  pictures, 
namely,  the  scene  in  the  cave,  emerged  into  consciousness 
as  an  hallucination  when  the  flash  of  light  occurred. 

2.  The  dream  was  of  picking  her  way  over  a certain  rocky 
path  which  was  covered  with  cats.  She  picked  her  way  to  avoid 
stepping  on  the  cats,  and  shrank  and  wriggled  as  she  placed  each 
foot  to  avoid  the  cats. 

Now  after  waking  from  this  dream,  during  that  same 
day,  the  subject  frequently  had  a feeling  that  she  was  going 
to  step  on  something  disagreeable,  and  frequently  looked 
to  see  what  she  was  stepping  on,  to  see  if  there  was  some- 
thing there.  Each  time  she  shrank  from  this  possible  some- 
thing just  as  she  had  in  the  dream.  Coincident  with  this 
feeling  of  stepping  on  something  disagreeable  there  came 
coconscious  pictures  of  the  cats  on  the  rocky  path — revivals 
of  the  dream  cats  under  her  feet. 

3.  During  the  afternoon  preceding  the  dream  while  tearing 
up  some  letters  referring  to  an  episode  in  her  life,  she  was  very 
much  disturbed  over  the  false  position  in  which  she  had  been 


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placed:  she  thought  “I  cannot  move  in  the  matter.”  The  dream 
symbolized  these  thoughts:  for  in  it  she  was  told  by  a certain 
person,  the  writer  of  the  letters,  that  she  could  not  move,  that  is, 
go  for  help;  and  thereupon  she  could  not — she  became  rigid. 

Now  the  next  day  there  were  coconscious  pictures  of  the 
person  of  her  dream,  and  when  these  pictures  came  she  could 
not  move  a step  even  though  at  the  time  she  was  crossing 
the  floor.  This  happened  half  a dozen  times  when  she  was 
up,  and  more  often  when  she  was  lying  down.  At  such 
times  she  would  become  rigid  for  a few  seconds  and  then 
the  picture  of  the  dream  personage  would  go  out  of  the 
subconscious  and  my  picture  would  come  and  she  could  move. 

3.  Repressed  Thoughts 

Many  instances  of  pictures  which  seemed  to  be  plainly 
the  visualizations  of  repressed  thoughts  were  observed. 
An  example  of  these  occurring  through  the  mediation  of  a 
dream  has  already  been  given.  The  following  illustrates 
their  occurrence  following  repression  without  such  media- 
tion. 

1.  On  one  occasion  the  ten  days  or  so  preceding  the  anni- 
versary of  her  husband’s  death  was  a time  of  distressing  associated 
memories  among  which  was  one  of  the  death-bed  scene.  Now, 
on  a certain  day  at  the  beginning  of  this  anniversary  period,  visual- 
izations of  this  death-bed  scene — of  the  room  and  the  bed,  of  her 
husband  sitting  on  the  side  of  the  bed,  of  Mrs.  X supporting  him, 
and  of  blood  coming  from  his  mouth— had  been  coming  and 
going  coconsciously  and  before  the  memory  of  it  came  into  her 
consciousness.  It  was  not  until  the  next  day  that  the  memory 
of  this  scene,  along  with  many  associated  ideas  pertaining  to  her 
husband,  entered  the  conscious  content  of  her  mind  and  then 
she  consciously  visualized  the  scene.  And  whenever  she  did  so 
a wave  of  nausea  arose.  (During  the  whole  period  she  suffered 
from  prolonged  headache.  The  deathbed  scene  itself  she  had 
not  actually  witnessed  but  it  had  been  described  to  her  by  a 
certain  Mrs.  X.,  her  husband  having  died  away  from  home.  The 
visualization  came  from  this  description.)  During  this  anniver- 
sary period  a great  many  other  distressing  memories  connected 
with  the  last  days  of  her  husband  crowded  into  her  mind.  She 
made  a great  effort,  however,  to  repress  them,  to  put  them  out  of 
her  mind  by  fixing  her  thoughts  on  other  things..  But,  as  another 


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Coconscious  Images 


subject  said,  “When  you  put  things  out  of  your  mind,  you  don’t 
put  them  out  of  your  mind,  you  put  them  into  your  mind.” 
And  so  she  succeeded  in  putting  them  out  of  her  mind,  in  re- 
pressing them,  but  only  to  have  them  reappear  as  pictures  in  C2,  and 
among  these  pictures  was  the  visualization  of  the  death-bed  scene, 
which  from  time  to  time  kept  recurring.  This  particular  cocon- 
scious visualization  was  always  accompanied  by  (“caused”?) 
waves  of  nausea  just  as  was  the  case  when  she  consciously  vis- 
ualized the  scene.  (This  occurrence  of  nausea  correlated  with 
distressing  coconscious  visualizations  of  other  scenes  had  been 
noted  before.) 

4 and  5.  Moods  and  Symbolisms 

Not  infrequently  these  visualizations  were  manifestly 
allegorical  representations  of  ideas  entertained  by  the  sub- 
ject, and  specifically  were  expressive  of  her  outlook  towards 
life  and  the  particular  problems  it  presented  to  her,  or  of  her 
relations  to  her  environment,  etc.  These  allegories  took 
different  shape  according  to  her  emotional  mood,  varying 
as  she  was  elated  or  depressed.  Evidently  there  was  a close 
correlation  between  these  coconscious  phenomena  and  the 
contemporary  mood,  i.  e.  the  affective  coloring  of  con- 
sciousness, the  former  appearing  to  determine,  or  at  least 
reflect  the  latter,  or  vice  versa;  or  as  may  be  more  probable 
both  being  determined  by  deeper  subconscious  processes 
from  which  the  affect  emerged.  A few  examples,  out  of 
many  that  might  be  given,  will  make  clear  what  I mean. 

1.  Often  when  the  subject  felt  full  of  courage,  but  not  really 
happy,  according  to  the  introspective  statement  given  by  the 
hypnotic  personality,  there  would  be  in  C2  the  picture  of  a man 
toiling  up  a steep  mountain  side,  with  a heavy  pack  on  his  back. 
If  she  felt  hopeful  the  mountain  looked  bright  at  the  top,  but  if 
she  felt  doubtful  about  accomplishing  whatever  it  was  she  wanted 
to  do  the  mountain  top  was  in  the  clouds. 

Sometimes  the  road  up  the  mountain  seemed  very  rough, 
and  at  others  it  was  smooth,  according  as  she  felt.  On  one  occa- 
sion, for  instance,  the  subject  “was  more  depressed  than  she  had 
been  for  a long  time.  She  felt  as  if  she  simply  could  not  bear  a 
disappointment  which  had  come  to  her.  There  was  not  one  bright 
or  hopeful  thought  in  her  mind.  She  felt  that  she  had  come  to 
the  end  of  her  endurance  and  was  ready  to  give  up  the  fight. 

Now  the  correlated  coconscious  picture  was  of  a road  “so 


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rough  as  to  be  almost  impassable;  the  man  was  bent  under  the 
weight  of  his  load  and  the  top  of  the  mountain  was  hidden  by 
black  clouds.”  After  a psychotherapeutic  talk  “the  picture 
was  still  there  but  changed.  The  clouds  had  lifted  from  the  top 
of  the  mountain  and  the  atmosphere  had  cleared.  The  man  was 
still  toiling  up  the  mountain  side  but  he  stood  up  straight  and  the 
road  was  not  so  rough.  The  man  in  this  picture  looked  a little 
like  Pilgrim  in  ‘Pilgrim’s  Progress.’  He  had  on  a sort  of  frock, 
belted  at  the  waist  and  reaching  to  his  knees  and  heavy  laced 
boots,  quite  high.  His  hair  was  long  and  he  had  no  hat.  His 
bundle  was  slung  over  his  shoulder  on  a stick.”  With  the  change 
in  this  picture  there  came  a change  in  the  subject's  thoughts  and  feel- 
ings: “She  felt  some  hope  and  courage,  some  strength  to  meet  the 
demand  made  upon  her.  She  felt  that  she  had  exaggerated  the 
importance  of  the  matter  which  had  disturbed  her  and  that  she 
ought  to  be  very  thankful  that  it  was  no  worse,  but  still  felt  de- 
pressed and  sad,  though  stronger.  ” 

It  will  be  agreed,  I think,  that  if  the  subject  had  wanted 
to  picture,  allegorically,  her  conception  of  the  road  of  life 
which  she  had  to  travel  and  its  final  goal,  according  to  her 
mood,  she  could  not  have  voluntarily  done  it  better.  But 
this  allegory  can  not  be  construed  as  a wholly  new,  original 
subconscious  fabrication  of  the  moment.  She  had  previous- 
ly often  consciously  thought  of  the  road  of  life  which  she  had 
to  travel  in  similar  allegorical  terms  and  this  rough  rocky 
road  had  appeared  in  her  dreams.  Such  thoughts  therefore 
were  conserved  when  out  of  mind  in  the  subconscious,  and 
we  are  permitted  to  infer,  from  all  that  we  know  of  the  sub- 
conscious, that  they  took  on  functional  activity  and  by  some 
mechanism  manifested  themselves  through  these  cocon- 
scious  pictures.  They  had,  however,  in  the  allegory  under- 
gone much  secondary  elaboration.  The  coloring  of  the  con- 
scious content  of  the  mind  by  the  affect  belonging  to  a sub- 
conscious process  is  a phenomenon  which  has  been  fre- 
quently demonstrated.4  Although  in  a given  instance  the 
subconscious  source  of  the  affect  may  not  be  clear,  in  other 
instances  there  seems  no  room  for  doubt. 

2.  Another  set  of  cinematographic  pictures  appeared  about 
this  time.  The  scene  was  my  office.  I was  “blowing  bubbles — 

4See  Prince:  The  Unconscious,  Chapters  XII,  XIII,  XXVI. 


302 


Coconscious  Images 


gorgeous  great  bubbles — and  there  were  pictures  of  herself  holding 
out  her  hands  to  catch  the  bubbles.  And  then  the  bubbles  burst. 
When  the  bubble  was  there  she  felt  elated,  and  when  it  burst  she 
felt  depressed.  ” 

These  pictures  can  be  rationally  interpreted  as  an 
allegorical  representation  of  actual  psychotherapeutic  ex- 
periences. I was  in  the  habit  of  encouraging  her  with  rose- 
ate plans  for  her  future,  of  what  she  could  do  in  the  way  of 
literary  and  other  work  to  solve  her  problem  of  life.  But 
these  plans  almost  always  “burst”  and  for  one  reason  or 
another  came  to  naught.  This  too,  was  her  point  of  view 
and  caused  considerable  unhappiness.  With  the  acceptance 
of  the  plans,  however,  she  was  always  highly  elated,  but 
when  they  finally  “burst”  she  became  correspondingly  de- 
pressed. 

3.  There  were  certain  lines  upon  courage  which  had 
appealed  to  her  and  which  appeared  at  times  as  visualized 
words  in  C2  but  without  coming  into  the  conscious  content 
of  her  mind.  These  lines  began: 

“Of  wounds  and  sore  defeat 
I made  my  battle-stay, 

Winged  sandals  for  my  feet 
I wove  of  my  delay.  ” 

When  these  words  appeared  she  felt  more  courageous  and 
had  more  endurance. 

4.  Again,  it  was  observed  that  at  times  in  the  C2  part 
of  her  mind  there  was  a curious  religious  connection  with  her 
mood. 

Thus  when  she  felt  very  depressed  and  rebellious  there  was 
a picture  of  Christ  on  the  Cross.  Correlated  with  this  picture, 
of  which  of  course  there  was  no  awareness,  her  conscious  thoughts 
at  the  moment  were  of  undeserved  suffering.  She  realized  that 
suffering  is  not  always  a punishment  for  sin  (as  Christ's  was  noth 
or  happiness  the  reward  of  virtue.  A hen,  on  the  other  hand,  she 
felt  peaceful  and  her  mind  was  more  or  less  at  rest,  the  picture 


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became  that  of  Christ  calming  the  waters.  He  stood  with  Hi? 
Hands  outstretched.  Sometimes  there  were  words  there,  like. 
“Let  not  your  heart  be  troubled,”  “Yea,  though  I walk  through 
the  valley  of  the  shadow,”  etc. 

5.  It  was  noted  that  after  a therapeutic  talk,  when 
she  felt  “hopeful  and  sometime  exalted,  there  would  be  in 
Cz  coming  and  going,  pictures  of  meadows  with  lambs 
frisking  about,  children  dancing  around  the  May-Pole, 
flowers  and  music,  beautiful  landscapes  with  the  sun  bright 
and  shining;  everything  gay  and  light.  When,”  the  testi- 
mony ran,  “there  is  music  in  Cz  or  sound,  it  is  a perception, 
not  a visual  picture.  ” 

The  subject  volunteered  the  suggestion  that  it  seemed 
to  her  “that  in  this  Cz  part  of  her  mind  could  be  found  the 
explanation  of  many  seemingly  strange  things.  Certain 
perceptions  may  be  registered  in  C2  of  which  the  personality 
is  unconscious  and  those  perceptions  may  work  themselves 
out  in  various  ways.  This  may  account,  sometimes,  for 
the  moods  of  depression  or  gaiety  for  which  we  know  no 
reason.”  This  interpretation  is  borne  out  by  a number  of 
these  phenomena  which  occurred  following  conditions  of 
which  the  subject  was  ignorant  even  in  that  state  of  hypnosis 
in  which  the  images  were  recalled.  For  instance,  when 
on  certain  occasions  in  the  course  of  conversation  with  the 
subject  in  another  hypnotic  state,  of  which  the  one  in  ques- 
tion had  no  knowledge,  I had  given  her  information  on  cer- 
tain subjects,  coconscious  pictures  illustrative  thereof  had 
later  appeared.  Neither  the  waking  nor  the  informing 
hypnotic  personality,  of  course,  had  memory  of  these  con- 
versations and  therefore  was  “unconscious”  of  the  source 
of  the  images.  The  subconscious  knowledge  manifested 
itself  through  coconscious  visualizations.  Thus,  on  one 
occasion  there  was  a picture  of  a bride;  a dead  man  lying  in 
his  coffin,  and  a woman  dressed  in  black,  like  a widow.  The 
bride  and  the  widow  were  the  same  woman.  This  picture 
represented  what  I had  told  her  while  in  a different  state  of 
hypnosis  of  a certain  mutual  acquaintance.  The  correlated 
conscious  thoughts  of  the  subject  at  the  time  concerned  the 
woman  of  the  picture. 


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6.  One  of  the  most  elaborate  and  psychologically  in- 
teresting of  these  allegorical  and  symbolic  pictures  is  the 
following: 

At  one  time  she  had  a habit  of  putting  her  hand  unconsciously 
to  her  left  breast,  particularly  if  a stranger  was  present  or  if  a 
number  of  people  were  in  the  room.  I had  noticed  her  doing  this 
several  times.  On  investigation  it  transpired  that  when  she  made 
this  gesture  there  developed,  coconsciously,  pictures  of  her  initials 
embroidered  in  red,  quite  large,  fanciful,  corresponding  to  the 
description  of  the  “scarlet  letter”  in  Hawthorne’s  novel  of  that 
name.  It  will  be  remembered  that  the  letter  as  there  described 
is  an  embroidered  capital  letter. 

The  history  of  the  development  of  this  phenomenon  is  » 
as  follows : 

I had  made  use  of  the  subject,  incognito,  on  one  occa- 
sion, to  demonstrate  hypnotic  phenomena  before  the  medical 
students  at  the  school.  Later,  on  reading  an  article  of  mine 
on  the  “Unconscious”,  she  came  across  a reference  to  her 
own  case.  She  did  not  recognize  at  the  time  that  this,  in 
connection  with  the  school  demonstration,  would  disclose 
her  identity,  but  nevertheless,  at  the  moment,  there  occurred 
the  coconscious  thought  of  which  she  was  not  aware:  “Now 
she  is  branded.”  And  right  after  that,  within  a few  moments , 
the  coconscious  picture  of  her  initials  came.  It  should  be 
explained  that  for  a long  time  she  had  been  dominated  by 
the  idea  that  if  it  should  be  known  that  she  exhibited  sub- 
conscious phenomena  a social  stigma  would  be  fastened 
upon  her  and  would  affect  her  socially.  This  formed  a sort 
of  complex  which  troubled  her. 

Now  it  so  happened  that  a day  or  two  still  later  she 
attended  a lecture  of  mine  at  the  hospital  and  she  noticed 
that  some  women  students  looked  at  her  and  whispered 
among  themselves.  At  the  time  she  thought  that  it  was 
because  she  had  been  exhibited  at  the  medical  school  and 
was  slightly  annoyed.  When  she  got  home,  for  some  reason 
or  other,  it  flashed  into  her  mind  (emergence  of  the  previous 
coconscious  knowledge?)  that  I had  described  in  the  pub- 
lished article  the  vision  which  she  reproduced  for  me  at  the 
school.  The  thought  at  once  came  to  her,  “Now  the}"  will 


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3°5 


know  me.”  She  felt  “terrible,  torn,”  etc.,  and  wrote  me  a 
letter  in  which  she  said,  “I  feel  as  if  I bore  three  scarlet 
letters  on  my  breast”  (emergence  from  the  coconscious). 
And  when  she  wrote  these  words  a coconscious  picture  of 
Arthur  Dimmesdale  developed,  and  it  was  after  this  that 
she  made  the  gesture  of  putting  her  hand  to  her  breast. 

For  a time  the  initials  and  the  picture  of  Arthur  Dim- 
mesdale constantly  kept  coconsciously  coming  and  going 
accompanied  by  the  gesture.  To  take  a specific  instance: 
When  I first  noticed  the  gesture  I had  just  asked  her  about 
her  repressed  thoughts,  and  then  the  gesture  occurred. 
The  question  had  brought  to  her  mind  the  thought  of  her 
illness,  and  then,  according  to  the  hypnotic  personality,  the 
coconscious  initials  came.  It  was  as  if  the  subconscious 
“stigma”  complex  was  awakened  by  thoughts  of  illness,  etc. 
“After  the  letters  came  a picture  of  Arthur  Dimmesdale, 
and  then  she  put  her  hand  to  her  breast.  The  picture  of 
Arthur  Dimmesdale  resembled  that  of  the  description  in 
the  book,  tall,  slender,  clerical  dress,  pale,  with  his  hands 
on  his  breast.  ” 

When  examining  this  statement  it  will  be  noted  that 
the  coconscious  initials  first  followed  immediately  after  a 
coconscious  thought — “Now  she  is  branded” — without  con- 
scious awareness  thereof.  Second,  that  it  w^as  not  until  a 
day  or  two  later  that  the  coconscious  knowledge  flashed 
into  her  mind  that  her  identity  would  be  known  and  she 
felt  that  she  bore  three  scarlet  letters  on  her  breast  (brand- 
ed), coincidentally  with  the  coconscious  picture  of  Arthur 
Dimmesdale  (and  the  initials?).  Third:  The  behavior  of 
the  whole  was  as  if  an  associated  subconscious  “stigma” 
complex  was  awakened  in  which  the  initials  and  the  picture 
of  Arthur  Dimmesdale  were  incorporated  as  elements. 
Fourth:  It  is  also  worth  noting  that  this  subconscious  com- 
plex, apparently,  induced  the  somatic  phenomenon,  the 
gesture,  which  was  performed  automatically  (involuntarily) 
and  almost,  if  not  wholly,  unconsciously. 

6.  Hallucinations 

It  has  already  been  stated  that  occasionally  one  or 


3°6 


Coconscious  omages 


more  of  the  visualizations  emerged  into  consciousness.  I 
want  now  to  point  out  in  more  detail  how  such  an 
emergence  may  result  in  an  hallucination:  That  is  to  say 
how  what  is  at  one  moment  a coconscious  “picture,”  not 
integrated  with  the  content  of  consciousness,  may  suddenly 
emerge  and  the  subject  become  aware  of  it  not  as  a visual 
image  belonging  to  the  conscious  stream  of  thought,  but  as 
an  hallucination.  In  this  we  have  one  mechanism  at  least 
by  which  hallucinations  may  be  produced.  More  concretely, 
this  mechanism  may  be  stated  as  follows. 

There  occurs  a subconscious  process  dissociated  from 
and  independent  of  the  stream  of  consciousness.  One  ele- 
ment in  this  process  is  a visual  image.  This  image  emerges 
and  the  subject  becomes  aware  of  it;  but  the  image  is  still 
dissociated  from  and  independent  of  the  content  of  the 
stream  of  consciousness — that  is  it  is  an  hallucination.  Its 
behavior  is  as  if  it  was  an  image  pertaining  to  a second 
process  which  had  not  entered  awareness  and  which  was 
(more  or  less)  independent  of  the  conscious  train  of  thought 
of  the  moment  but  coincident  with  it.  I have  observed 
several  examples  of  this  phenomenon.  The  following  is  an 
illustration: 

On  the  anniversary  of  her  wedding,  during  the  day  she  had 
been  trying  to  keep  out  of  her  mind  the  thought  of  what  day  it 
was — had  tried  to  make  herself  think  it  was  just  like  any  other 
day.  But  at  times  the  realization  of  the  day  would  come  to  her. 
About  9:30  in  the  evening  she  let  herself  go- — let  her  thoughts  flood 
through  her  mind.  She  was  sitting  in  her  room,  looking  out  of 
the  window,  thinking  of  the  day  and  all  that  it  meant,  of  the 
members  of  the  family  and  others  who  were  dead.  Then  her 
thoughts  began  to  roam  over  a future  life,  wondering  if  people 
had  any  consciousness  of  this  life  and  knew  what  was  going  on — 
whether  they  knew  each  other  as  here,  had  memories  of  this  life. 
In  other  words  she  thought  of  them  as  spirits  and  not  as  they  were 
in  this  life. 

While  she  was  thinking  all  this  there  developed  coconscious 
pictures  of  her  father  and  mother  and  of  her  relatives  who  are 
dead,  of  herself  as  a bride,  as  she  was  dressed,  (although  she  was 
not  thinking  of  herself  as  a bride  at  all)  and  there  was  a picture  of 
her  dead  husband.  This  :vas  brighter  than  the  others. 

Then  suddenly  she  had  a peculiar  feeling.  She  felt  a cold 
draft  and  turned  suddenly  and  looked  towards  the  hall  of  the 


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apartment  where  there  was  a light  (there  was  none  in  the  room), 
and  there,  midway  in  the  room,  was  a vision  of  her  husband. 
It  was  luminous,  a brightness,  in  the  centre  of  which  was  a figure 
which  merged  into  the  brightness.  No  sharp  outline  of  form  ex- 
cepting the  face  and  head  which  were  distinct  and  bright.  The 
whole  was  radiant. 

Now  the  point  to  be  noted  is,  just  before  the  vision  the  cocon- 
scious  pictures  were  there.  Then,  at  the  moment  when  the  vision 
appeared,  all  these  pictures  vanished  excepting  the  bright  vision 
of  her  husband.  This  emerged  as  a conscious  image,  i.  e.  she 
become  aware  of  it,  but  as  an  hallucination.  This  interpretation, 
based  on  the  subject's  retrospection  of  the  events,  is  fortified  by 
the  fact  that  objectively,  as  seen  in  retrospection,  the  coconscious 
image  and  the  hallucinatory  image  were  “just  the  same”  in  details, 
were  identically  appearing  pictures.  To  the  subject,  from  one 
point  of  view,  it  seemed  that  she  had  suddenly  become  aware  of 
something  of  which  she  had  a moment  before  been  unaware.  The 
image  (vision)  of  her  husbapd  had  been  there  before  but  it  had 
been  coconscious. 


7.  Perseveration 

Examples  of  perseveration  of  antecedent  conscious  ex- 
periences manifested  in  these  coconscious  pictures  will  be 
found  running  through  many  of  these  observations  and 
need  not  be  further  elaborated. 

* * * 

In  my  second  case  a very  large  number  of  observations 
of  the  same  phenomena  were  made.  They  were  not,  how- 
ever, so  systematically  studied  with  a view  to  their  correla- 
tion with  other  phenomena,  but  they  occurred  under  the 
same  conditions  and  exhibited  the  same  characteristics. 
It  would  be  largely  a repetition  to  record  them. 

Dr.  Waterman  has  given  me  the  following  account  of 
a third  case  which  he  permitted  me  to  observe  also  on  one 
occasion. 


Dr.  G.  A.  Waterman’s  Case 

A woman  of  thirty  applied  to  me  for  treatment  of  her  condi- 
tion which  she  termed  kleptomania.  Her  trouble  consisted  in  the 


3°8 


Coconscious  Images 


habit  of  taking  jewelry  whenever  she  came  across  it  on  the  counters 
in  stores.  She  never  had  taken  any  of  the  jewelry  home  but  would 
find  herself  with  it  gathered  in  her  hands;  at  this  juncture  she 
always  became  frightened  at  the  realization  of  what  she  was  doing 
and  would  put  it  back  on  the  counter  and  hurry  from  the  store. 
A careful  analysis  of  her  mental  state  at  such  times  revealed  no 
evidence  of  any  impulse  to  take  the  jewelry  nor  did  she  have  any 
desire  for  it,  being  the  wife  of  a man  in  affluent  circumstances. 

After  trying  during  several  visits  to  discover  the  mechanism 
that  was  giving  rise  to  her  troublesome  condition,  I resorted  to 
hypnosis.  A state  of  complete  hypnosis  was  readily  obtained,  the 
patient  becoming  relaxed  and  anaesthetic.  On  being  asked  in  this 
state  what  was  the  cause  of  her  trouble  she  at  once  replied  that 
it  was  a dream  that  she  had  had  a year  and  a half  previously  of 
which  she  had  never  been  conscious  in  her  waking  state.  The 
memory  of  the  dream,  however,  was  still  as  vivid  to  her  in  hypno- 
sis as  it  was  the  day  after  she  dreamed  it. 

The  patient  dreamed  that  she  was  standing  before  a counter 
on  which  was  displayed  a pile  of  glittering  jewels.  A burglar 
stood  before  her  and  in  a threatening  manner  commanded  her  to 
steal  the  jewels  for  him.  She  pleaded  to  be  allowed  to  go,  but  he 
exclaimed,  “if  you  do  not  steal  them  I will  have  your  mother 
murdered.”  It  seemed  at  the  time  that  her  mother  was  in  an 
adjacent  room,  separated  from  her  only  by  a partition,  and  she 
could  hear  her  groaning.  Overcome  with  anxiety  for  her  mother 
she  seized  a handful  of  jewels,  but  on  looking  down  at  them  she 
realized  what  she  was  doing  and  looked  up  weeping  at  the  burglar 
to  ask  him  to  let  her  go.  At  this  point  she  awoke  sobbing.  Her 
husband  beside  her,  who  had  been  awakened  by  her  distress, 
asked  why  she  was  crying  and  she  answered  “I  do  not  know,  I 
must  have  had  a bad  dream.”  For  she  had  no  conscious  memory 
of  her  dream.  It  was  shortly  after  this  that  she  found  herself 
taking  jewelry  in  the  stores. 

(It  happens  that  two  of  the  elements  of  this  dream  were  associ- 
ated with  distressing  circumstances  of  the  patient’s  life : — First: 
the  burglar  as  he  appeared  in  the  dream  was  the  same  one  who 
had  featured  in  a terrifying  experience  in  the  patient’s  early  life; 
for  at  the  age  of  twenty  she  had  been  held  up  by  this  man  at  the 
point  of  a revolver  and  at  the  time  really  had  a narrow  escape. 
Second: — About  the  time  the  patient  had  the  dream  her  mother 
had  been  taken  ill  and  was  told  that  she  had  hardening  of  the 
arteries  and  could  not  live  very  long.  This  had  caused  the  patient 
great  anxiety.  It  is  therefore  natural  that  both  of  these  factors 
in  her  dream  were  associated  with  strong  emotions.) 

While  the  patient  was  still  hypnotized  she  was  asked  in  what 
way  this  dream  acted  on  her  mind  at  the  time  she  took  jewelry  in 
the  stores.  She  said  that  whenever  she  saw  jewelry  on  a counter 


Morton  Prince 


3°9 


that  this  dream  recurred  to  her.  It  did  not  come  to  her  conscious- 
ly but  the  pictures  of  the  dream  were  coconscious  and  were  going  on 
independently  of  the  train  of  thought  in  her  conscious  mind. 

In  order  to  illustrate  the  mechanism  of  her  dream  and  its 
relation  to  her  trouble  I placed  a key  in  a leather  case  and  put 
the  case  on  a couch  across  the  room,  and  while  the  patient  was  still 
under  hypnosis  told  her  that  when  she  awakened,  at  the  moment 
I raised  the  shade  next  my  desk,  that  she  would  walk  across  the 
room,  pick  up  the  case,  open  it  and  take  out  the  key.  A short 
time  after  this  the  patient  was  awakened  and  while  she  was  ar- 
ranging her  hat  at  a mirror  across  the  room  I raised  the  shade. 
At  once  she  walked  slowly  across  the  room  conversing  with  me 
about  certain  social  things  that  she  had  been  doing  the  day  before 
and,  passing  behind  me,  picked  up  the  case  on  the  couch.  At  this 
juncture  I turned  and  saw  her  standing  with  the  key  in  her  hand 
and  looking  at  it  with  a puzzled  expression.  The  following 
conversation  ensued: — 

Q. — “What  are  you  doing?” 

A.  “I  do  not  know. ” 

Q.  “Why  have  you  that  key?” 

A.  “ I don’t  know.  ” 

Q.  “Don’t  you  know  that  it  is  a kev  of  mv  private  box?” 

A.  “No.” 

Q.  “Don’t  you  think  that  some  explanation  is  needed  when 
you,  behind  my  back,  open  a case  and  take  the  key  to  mv  private 
box?” 

Patient  flushing  and  looking  embarrassed:  “I  don’t  know 

what  to  say,  I am  sure  I am  very  sorry.” 

Q.  “What  was  in  your  mind,  what  were  you  thinking  of 
when  you  did  it?” 

A.  “I  really  was  only  thinking  of  what  I was  talking  to  you 
about,  about  going  to  the  theatre,  etc.” 

“Surely,”  I said,  “there  must  have  been  some  cause.  Per- 
haps it  was  not  in  your  conscious  mind,  let  us  see  if  we  cannot  find 
it.” 

The  patient  was  hypnotized  again  and  asked  what  made  her 
open  the  case  and  take  out  the  key.  She  at  once  replied,  “Why, 
pictures  of  myself  doing  it;"  and,  on  being  further  questioned, 
described  the  flow  of  coconscious  pictures  of  herself  performing  the 
act.  She  said  that  at  the  time  these  pictures  were  acting  in  her  mind 
she  herself  was  correspondingly  performing  the  act. 

After  explaining  the  relationship  of  the  subconscious  with  the 
act  performed,  and  making  her  see  the  connection  between  the 
experiment  in  the  office  and  her  actions  in  real  life  the  patient  was 
awakened.  She  was,  of  course,  amnesic  to  all  that  had  taken 
place  in  hypnosis,  but  the  same  explanation  was  made  to  her  in 


3ID 


Coconscious  Images 


the  waking  state  with  the  result  that  she  was  no  longer  troubled 
by  her  so-called  kleptomania. 

* ❖ Jjc 

What  is  the  meaning  of  these  phenomena?  With  what, 
if  any,  normal  psychological  events  can  they  be  identified? 
What  part  do  they  play  in  the  mechanisms  by  means  of 
which  the  mind  functions?  Are  they  solely  abnormal 
phenomena,  or  have  they  normal  prototypes,  the  conditions 
only  (dissociation,  repression,  etc.)  under  which  they  func- 
tion being  abnormal?  Have  we  in  them  something  which 
throws  light  on  the  subconscious  workings  of  the  mind? 

These  are  some  of  the  questions  which  at  once  come 
to  mind  and  invite  answer. 

Looking  at  them  without  regard  to  their  relation  to  the 
content  of  consciousness  and  the  conditions  under  which 
they  occurred — e.  g.  whether  within  or  without  the  field  of 
awareness — it  is  obvious  that  they  must  in  themselves  be 
psychical  events  that  are  found  in  normal  mental  processes. 
For  the  abnormal  is  only  the  normal  functioning  under 
altered  conditions.  It  is  inconceivable,  therefore,  that 
they  are  new  elements  of  consciousness  in  the  sense  of  new 
creations  unknown  to  psychological  processes.  In  fact 
they  are  images  and  as  such  are  normal  elements  of  con- 
sciousness. Now  images  occur  in  the  course  of  normal 
mentation  only  in  three  forms:  as 

(a)  real  sensational  events,  as  in  perceptions  of  the 
environment; 

(b)  sense  elements  (imagery)  of  thought; 

(c)  hallucinations.  In  this  class  dream  imagery 
would  be  included. 

We  must  see  whether  the  images  in  question  can  be 
identified  with,  or  are  akin  to  any  of  these  known  types 
before  postulating  another  species. 

The  first  type  (a)— perceptions  of  the  environment — 
can  be  excluded  at  once. 

As  to  their  kinship  to  thought  imagery  (b) : If  we  accept 
the  theory  (fairly  well  established)  that  there  are  normally, 
as  well  as  -abnormally,  subconscious  processes — processes 
of  a psychical  nature  which  do  not  enter  awareness,  and  if 


Morton  Prince 


3ii 

we  assume  that  these  processes  are  akin  to,  if  not  technically 
identical  with  thought,  then  we  should  expect  that  they 
would  include  images  of  the  same  pattern  and  behavior  as 
those  of  conscious  thought.  They  would  include  visual 
and  auditory  images,  the  so-called  secondary  sensational 
elements  (perceptions)  which  are  found  amongst  the  com- 
ponents of  the  complex  called  an  “idea;”  and  they  would 
either  be  more  or  less  persistent  and  unchanging,  or  would 
follow  one  another  in  pictorial  (cinematographic)  sequence 
correspondingly  with  the  fixity  or  flux  of  thought. 

Under  this  hypothesis  the  coconscious  images  recalled 
in  retrospection  would  be  only  these  particular  sensational 
components  of  subconscious  “ideas.”  As  images  they 
would  not  differ  from  those  of  ordinary  thought  imagery 
except  that  they  are  coconscious  and  do  not  therefore  emerge 
into  awareness.  Why  the  rest  of  the  subconscious  “idea,” 
or  process,  is  not  revived  as  memory,  but  only  the  sensational 
elements,  is  another  question  and  one  which  probably  can 
not  be  answered  satisfactorily.  The  fact  would  imply  that 
the  rest  of  the  “idea,”  or  thought  process,  is  more  intensely 
dissociated  from  awareness  than  the  sense  images.  But 
why  it  should  be  so,  one  cannot  say.  But  after  all,  what 
is  a thought  process,  an  “idea”,  any  way,  and  what  are 
its  other  components  ? Verbal  images  (visual,  auditory  and 
kinesthetic)  may  be  components,  but  not  necessarily,  as 
in  deaf  mutes.  Perhaps  images  of  objects  are  the  most 
dynamic  elements  and  that  is  why  they  alone  have  sufficient 
intensity  and  vividness  to  be  recalled  in  memory.  The 
same  problem  attaches  to  the  imagery  of  dreams. 

Hypothetically  it  is  conceivable  that  the  rest  of  the 
subconscious  process  is  purely  neural  and  that  the  activity 
of  the  sense  neurons  alone  has  correlated  psychical  elements 
(images).  Hence  memory  can  only  recall  the  latter. 

As  to  their  kinship  with  hallucinations  and  particularly 
dream  imagery  (c) : Their  resemblance  in  behaviour  and 
vividness  to  dream  imagery  is  quite  striking  and  suggests 
that  we  are  dealing  with  the  same  mechanisms.  Indeed  the 
recurrence  as  coconscious  images  of  the  dream  imagery, 
followed  by  their  secondarily  resulting  somatic  and  psycho- 
logical phenomena  {e.  g.  flashes  of  light  and  blindness  in  one 


312 


Coconscious  Images 


example),  in  the  waking  state  would  seem  to  indicate  this 
identity  of  the  mechanisms.  That  in  dreams  the  imagery 
is  only  the  conscious  emergence  of  a larger  subconscious 
mechanism  there  is  strong  evidence  to  believe.  The  same 
is  true  of  the  imagery  of  “crystal  visions,”  i.  e.  artificial 
hallucinations,  and  hypnogogic  hallucinations.  In  these 
phenomena  and  dreams  the  imagery  takes  on  a cinemato- 
graphic character  as  is  often  the  case  in  the  images  under 
consideration.  As  indicative  of  a subconscious  process  may 
be  mentioned  the  fact  that  in  the  production  of  artificial 
hallucinations  the  subject,  as  he  sees,  let  us  say,  himself  in 
the  vision,  knows  what  the  vision-self  is  thinking  about 
and  feels  the  emotion  manifested  in  the  expression  of  the 
vision-face  and  exhibits  the  same  expression  in  his  own  face. 
This  subconscious  process  in  such  hallucinations  and  dreams 
must  be  at  least  akin  to  “thought”  if  not  technically 
thought.  If  such  be  the  case  then  hallucinatory  imagery 
and  dream  imagery  may  be  explained  as  the  conscious 
emergence  of  the  secondary  images  pertaining  to  such 
“thought.  ” 

By  this  process  of  reasoning  we  arrive  at  the  conclusion 
that  the  mechanism  of  the  imagery  in  types  b (thought) 
and  c (hallucinations)  is  (may  be)  pragmatically  the  same, 
and  that  the  coconscious  images  in  question  are  identical 
with  normal  images,  but  belong  to  subconscious  processes 
of  “thought.” 

How  far  the  subconscious  process  pertains  only  to  ab- 
normal conditions  and  how  far  to  normal  conditions  is  an- 
other problem.  It  is  sufficient  here  to  say  that  a mass  of 
evidence  at  our  disposal  indicates  that  subconscious  processes 
are  normal  as  well  as  abnormal  phenomena. 

As  to  the  relations  between  the  coconscious  images  plus 
their  subconscious  processes  and  other  coconscious  thoughts 
— thoughts  which  may  be  described,  if  one  prefers,  as  out- 
side the  field  of  awareness,  or  focus  of  attention,  or  in  the 
background  of  the  mind — and  the  conscious  field  I would 
offer  the  following  considerations. 

In  the  first  place,  the  images  are  always  (?)  expressions 
of  antecedent  thoughts,  often  after  secondary  elaboration, 
sometimes  in  symbolic  fashion  as  in  dreams.  This  shows 


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313 


that  such  antecedent  thoughts,  although  out  of  mind, 
whether  because  of  repression  or  not,  do  not  necessarily 
remain  passive,  but  may  undergo  subconscious  incubation 
and  function  actively  but  outside  the  field  of  awareness. 

In  the  second  place,  when  other  coconscious  thoughts 
were  recovered  in  memory  by  retrospection  of  the  subject 
the  images  in  question  did  not  immediately  pertain  to  these 
thoughts  though  they  might  mediately  so  do.  For  example, 
take  the  coconscious  thought  “Now  she  is  branded”  (Obs. 
6;  symbolisms).  The  images  were  initial  letters  and  the 
picture  of  Arthur  Dimmesdale.  The  “thought,”  and 
images  did  not  seem  to  be  a unity  but  the  images  pertained 
to  associated  ideas.  In  other  instances  there  was  no  ap- 
parent association  though  it  may  have  been  through  roots 
not  revealed  to  the  memory  of  the  moment.  So  always 
when  contemporaneous  (or  sequential)  subconscious  thoughts 
and  images  were  recalled  by  the  subject  they  seemed  to  her 
separate  phenomena,  not  a unity  as  in  conscious  thought 
and  perceptions.  They  were  always  described  as  separate 
phenomena,  as  different  parts  of  the  mind  for  which  differ- 
ent terms  were  used.  The  interpretation  I would  suggest 
is  this: 

Our  conscious  experiences  are  integrated  into  systems 
of  associated  thoughts.  Any  given  experience  may  be 
linked  up  with  many  systems  each  one  being  a different 
setting  and  giving  a different  meaning  or  significance  to  the 
idea.  For  instance,  a shell  for  a ’75  cannon  may  be  inte- 
grated with  a problem  in  ballistics,  or  cannons,  or  with 
blood}^  warfare  in  the  trenches.  Again,  within  each  system 
there  are  subsystems.  Nearly-  every  idea,  then,  has  many 
ramifications  and  roots  in  systematized  antecedent  experi- 
ences. Any  thought  in  the  focus  of  attention,  or  one  in  the 
fringe  of  consciousness  of  the  moment  may,  through  such 
integration,  excite  into  activity  a system  outside  the  field  of 
awareness  and  thus  awaken  coconscious  thought.  This 
system  again  through  roots  may  indirectly  excite  another 
logically  distant  system — i.  e.  associated  subconsciously, 
say,  through  a single  element,  such  as  a verbal  symbo 
(“shell”).  From  this  system,  functioning  “subconsciously’ 
(S.  M.),  images  (CCI)  may  arise  outside  the  field  of  aware- 


3I4 


Coconscious  Images 


ness  (coconscious).  These  images  CCI  when  recalled 
through  retrospection  will  thus  appear  to  be  unsystematized 
with  the  contemporaneous  coconscious  thought  (CCT)  also 
recalled  in  the  same  way. 

This  mechanism  may  be  diagrammatically  represented 
as  follows: 


The  field  of  consciousness  and  of  the  subconscious  is  repre- 
sented by  circles. 

FA  Focus  of  attention. 

F Fringe  of  awareness. 

CCT  Coconscious  thought  outside  fringe  of  awareness 
(E.  g.  “Now  she  is  branded”)  integrated  indirectly  with  CCI. 

C C T\  C C T"  Quiescent  systems  of  antecedent  experiences 
integrated  more  or  less  directly  with  CCT  and  capable  of  being 
excited  to  activity  and  becoming  coconscious  thought,  or  the 
fringe,  or  attention. 

S.  M.  Subconscious  mechanisms  pertaining  to  F A,  C C T, 
C C T',  CC  T"  and  CCI. 

CCI  Coconscious  images  emerging  when  their  S M is  sub- 
consciously stimulated  by  an  associative  process. 


Morton  Prince 


315 


Affects:  The  emergence  into  consciousness  of  the  affect 
integrated  with  a subconsciously  functioning  system  is  of 
considerable  importance  for  psychiatry  and  psychopathology. 

I have  discussed  this  phenomenon  at  length  in  other  writ- 
ings.4 Exaltation  and  depression,  and  other  emotions  and 
feelings,  can  often  be  traced  to  the  activity  of  subconscious 
processes  giving  rise  to  moods  inexplicable  on  the  basis  of 
the  conscious  thoughts.  In  the  observations  here  recorded 
affective  states  of  the  subject  often  could  be  correlated  with 
the  coconscious  images.  It  is  obvious  that  in  melancholia 
we  shall  often  have  to  seek  for  the  source  of  the  depressive 
feelings  in  subconscious  processes  (the  residua  of  antecedent 
experiences)  rather  than  in  the  content  of  consciousness. 

Hallucinations:  The  phenomenon  of  a coconscious  image 
emerging  as  an  hallucination  gives  an  insight  into  at  least  one 
mechanism  of  this  clinical  symptom.  Whether  the  inter- 
pretation I have  given  of  the  relation  of  the  image  to  the 
process  is  the  correct  one  or  not,  we  have,  at  any  rate,  evi- 
dence that  an  hallucination  may  have  its  origin  and  mechan- 
ism in  a subconscious  process  and  that  this  process  is  the 
perseveration,  with  or  without  secondary  elaboration,  of 
antecedent  experiences. 

In  addition  to  what  I have  said  above  I think  we  are 
justified  in  drawing  the  following  conclusions: 

1.  Coconscious  images  are  elements  of  more  elaborate 
subconscious  processes. 

2.  They  may  be  explained  as  secondary  images  per- 
taining to  such  subconscious  processes. 

3.  They  may  emerge  into  consciousness  and  thereby 
become  hallucinations. 

4.  The  subconscious  processes  of  which  they  are  ele- 
ments are  perseverations  and  sometimes,  after  undergoing 
incubation,  elaborations  of  antecedent  experiences. 

5.  The  subconscious  processes  may  construct  sym- 
bolisms: and  further 

4 “The  Dissociation  of  a Personality,”  “The  Unconscious,”  and  various 
articles. 


3 16 


Coconscious  Images 


6.  They  may  determine  or  motivate  the  conscious 
streams  of  thought: 

7.  They  are  sometimes  derived  from  repressed 
thoughts. 

8.  They  often  provide  the  conscious  affect. 

9.  They  may  induce  dreams  on  the  one  hand  and,  on 
the  other,  may  be  derived  from  dreams. 

10.  They  may  induce  somatic  phenomena. 


A FURTHER  APPLICATION  OF  THE  PSYCHO- 
ANALYTIC METHOD* 


BY  H.  I.  GOSL1NE,  M.D. 

Pathologist , New  Jersey  State  Hospital , Trenton , N.  J. 
Formerly  Pathologist , Worcester  State  Hospital , Worcester , 

71/  aju. 

THE  chief  concern  of  the  following  paper  is  the  topic 
of  psychophysical  correlations  and  the  aid  which 
psycho-analysis  may  give  in  making  such  correla- 
tions. The  term  “psychophysical”  is  used  in  its 
broad  sense' here  and  not  in  the  sense  generally  under- 
stood and  expressed  in  words  when  we  say  that  “every 
mental  process  is  accompanied  by  a brain  process.”  For 
we  must  do  one  of  two  things  in  the  near  future:  either 
we  must  limit  the  number  of  so-called  mental  processes 
or  we  must  concede  that  certain  mental  processes  can  take 
place  without  a corresponding  process  in  the  brain.  For 
example,  certain  of  the  instincts  which  are  commonly  sup- 
posed to  stand  as  evidence  of  intelligence  are  associated  with 
definite  changes  in  the  glands  of  internal  secretion1  and 
recently  a case  has  been  cited  clinically  with  symptoms  and 
anatomical  findings  similar  to  those  in  the  hibernating 
animal.2  Here  might  also  be  included  recent  work  on  the 
emotions  and  the  internal  secretions  as  well  as  the  so-called 
vagotonic  constitution. 

There  are  several  ways  in  which  this  pruning  of  the  broad 
concept  of  the  mental  may  be  carried  out,  and  there  are 
many  advances  being  made  today  in  showing  that  the  men- 
tal, as  now  conceived,  is  associated  very  often  with  some- 
thing more  than  a brain  process,  or  is  carried  on  without  any 
demonstrable  brain  process,  if  a brain  process  cannot  be 
totally  excluded.  To  adequately  comprehend  the  position 
of  the  psychology  of  the  present  day  and  to  grasp  the  trend 

*Read  at  the  meeting  of  the  American  Psychopathological  Association  held 
on  May  24,  1917,  Boston,  Mass. 


3D 


3 1 8 Further  Application  of  the  Psycho- Analytic  Method 

of  modern  thought,  one  must  have  paid  some  attention  to 
the  philosophies  of  Schopenhauer,  Spencer,  Kant,  James, 
Nietzsche,  Bergson,  and  to  the  psychologies  of  Wundt, 
Kraepelin,  and  Munsterberg,  in  addition  to  the  psychology 
which  has  grown  up  about  the  psycho-analytic  method. 
Through  the  whole  of  philosophy  there  have  run  two  great 
undercurrents,  which  have  finally  come  to  forceful  expression 
in  the  recognition  by  James3  of  two  types  of  men,  the  “ten- 
der-minded” and  the  “tough-minded.”  And  through  the 
whole  of  psychology  there  have  been  two  dominant  tenden- 
cies, the  tendency  to  interpret  and  the  tendency  to  stick  to 
facts;  but  in  psychology,  as  in  everything  else  human,  the 
attempt  to  interpret  must  by  its  very  nature  lead  away  from 
facts.  Here  is  the  chief  cause  and  the  root  of  the  major  part 
of  the  difficulties  in  present-day  psychology.  An  ultimate 
resolution  of  this  conflict  will  come  of  itself  with  the  recog- 
nition that  the  human  mind  “is  characterized  by  causae  and 
fines”4  and  this  attitude  has  at  last  been  definitely  taken  by 
at  least  one  eminent  psychologist5  when  he  wrote  his  system 
under  the  “causal”  and  the  “purposive”  headings. 

This  paper  is  not  interested  in  taking  issue  with  the  pur- 
posive view-point  or  with  the  synthetic  and  prospective  side 
of  analytical  psychology6  or  with  the  purely  psychological 
view-point  even.'  They  have  a right  to  their  existence,  if 
they  satisfy  a need.  I am  not  interested,  therefore,  in  the 
question  of  how  far  psycholo-analysis  is  successful  in  “doing 
for  the  personality  what  surgery  has  done  for  the  body.” 
The  truth  or  falsity  of  the  significance  attached  to  the  two 
ways  of  thinking,  of  that  attached  to  the  libido,  of  the  inter- 
pretation of  symbols,  of  the  existence  or  non-existence  of  the 
unconscious  may  all  pass  by.  What  has  arisen  from  all  this 
is  a method  which  claims  to  be  analytic  and  causal  as  well 
as  synthetic  and  prospective  and  it  is  with  these  former 
aspects  that  I am  concerned  here.  It  is  these  aspects  which 
have  been  most  neglected  in  their  applications.  Whether  we 
agree  that  the  association  method  as  developed  by  Jung' 
can  give  us  reactions  which  depend  on  proportionate  emo- 
tional states,  or  whether  we  agree  with  Bleuler’s  ideas  on 
ambivalency  and  ambitendency  ajid  on  autistic  thinking,  or 
with  the  ideas  on  the  various  kinds  of  eroticism  as  commonly 


H.  I.  Gosline 


319 


expressed,  matters  little  for  the  purpose  of  this  paper.  It  is 
enough,  if  the  method  has  reduced  certain  mental  processes 
to  elements  whether  they  are  sexual  in  nature  or  whether 
they  are  reductions  to  archaic  thought  with  a history  extend- 
ing through  mythology,  poetry,  and  religion.  It  is  these 
reductions  which  we  may  use  and  the  criticism  of  the  reduc- 
tions and  of  the  methods  used  in  obtaining  them  may  be  left 
to  other  authorities  and  to  other  branches  of  thought. 

While  much  of  the  work  in  analytical  psychology  has  been 
devoted  to  the  development  of  a therapeutic  measure  and 
hence. has  been  obliged  to  concern  itself  with  the  purposive 
side  of  the  mental  life,  yet  the  inevitable  question  has 
appeared  from  time  to  time  as  to  whether  the  mental  diffi- 
culty was  primary,  or  secondary  to  some  somatic  difficulty 
and  the  replies  to  this  latter  assumption  have  grouped  them- 
selves along  two  definite  lines.  One  set  of  answers  is  con- 
cerned with  the  constitution,  the  heredity,  and  the  other 
is  concerned  with  the  question  of  brain  injury.  I imagine 
that  this  latter  will  have  to  be  extended  to  include  injury  to 
other  body  organs  also.  In  fact,  somatic  reasons  for  certain 
somatopsychic  delusions  have  already  been  pointed  out.9 

It  will  be  apparent  from  these  few  sketchy  lines,  I think, 
that  for  the  purpose  of  making  psychophysical  correlations, 
the  concept  of  the  mental  must  first  undergo  a limitation  or 
pruning  which  shall  include  that  whole  field  which  is  concerned 
with  the  purposive  side  and  the  therapeutic  side.  Such 
conception  of  the  ment’al,  by  its  very  manner  of  selection, 
does  not  purport  to  be  a view  of  the  totality  of  the  mental 
life.  It  only  proposes  a definite  manner  of  thinking  in  the 
service  of  a special  scientific  investigation.  Such  a manner 
of  thinking  I have  already  tried  to  outline10  in  the  matter 
of  the  mental  symptoms,  as  shown  by  the  patient.  There 
it  was  pointed  out  that  the  psychiatric  examination  is  a much 
broader  thing  than  the  purely  psychopathological  examina- 
tion and  that,  for  the  purpose  of  correlating  symptoms  with 
bodily  changes,  certain  signs  of  psychiatric  value  were  of 
little  worth.  The  simpler  words  are  the  more  objective  in 
describing  the  condition  of  the  patient  and  hence  are  the 
ones  more  likely  to  furnish  reliable  correlations.  At  that  time 
it  seemed  that  the  behavior  of  the  patient,  as  described  by 


320  Further  Application  of  the  Psycho- Analytic  Method 

those  simple  words  of  the  first  order  of  observation,  that  is, 
words  without  interpretative  elements,  was  the  thing  which 
might  yield  the  proper  correlations.  But  with  the  develop- 
ment of  the  psycho-analytic  method  has  come  a new  instru- 
ment for  the  analysis  of  the  more  complicated  productions 
of  the  patient,  the  productions  which  were  previously  too 
baffling.  Thus  our  field  for  correlations  may  prove  in  time 
to  be  greatly  extended. 

Now,  if  we  are  to  exclude  a certain  part  of  the  mental  life 
for  the  purposes  of  our  correlations,  it  is  no  less  necessary 
that  we  assume,  hand  in  hand  with  this,  a certain  organ 
inferiority  on  which  we  may  base  our  causal  connections. 
Whether  this  assumed  inferiority  is  primary  or  secondary 
to  the  mental  condition  is  not  in  dispute  here.  An  historical 
review  of  the  question  shows  definite  tendencies  of  two  types 
even  from  the  beginning  and  these  types  have  most  recently 
been  formulated.  Even  in  the  early  writings  of  Freud  we  see 
the  question  of  an  hysterical  predisposition11  mentioned. 
Jung,12  in  his  recent  book  on  Analytical  Psychology,  mentions 
the  same  questions  but  lays  more  emphasis  on  the  existence' 
of  psychological  types,  even  going  to  the  extent  of  saying 
that  the  question  of  types  is  the  question  of  our  psychology. 
Dr.  Adler,13  of  Vienna,  has  expressed  some  very  novel  ideas 
on  some  more  or  less  novel  observations  in  his  work  on  Organ 
Inferiority  and  Its  Psychical  Compensation.  That  part  of 
his  work  which  deals  with  enuresis  seems  to  take  the  trouble 
back  to  related  family  peculiarities.  But  the  chief  value  in 
his  work  is  to  me  the  theory  of  “ideological  superstructures” 
because  its  correlate  seems  to  be  that  we  can  get  a hint  of  the 
organ  at  fault  by  a psycho-analytic  examination  of  these 
superstructures. 

The  second  tendency  in  this  field  has  been  the  correlation 
of  certain  more  or  less  definite  groups  of  symptoms  with 
very  definite  alterations  in  various  parts  of  the  economy. 
This  work  must  be  conceded  chiefly  to  Dr.  Southard  and  his 
co-workers.  An  exhaustive  account  of  their  work  and  of  its 
results  would  be  impossible  here  and  would  serve  no  useful 
purpose  in  this  paper.  Suffice  it  to  say  that  certain  non- 
neural  processes  have  been  pointed  out  as  possible  basis  for 
certain  mental  phenomena  and  that,  on  the  other  hand,  there 


II.  I.  Gosline 


321 


is  a large  quota  of  mental  symptoms  which  have  very  defi- 
nite brain  correlates,  either  in  the  shape  of  agenesia  and 
hypoplasia  or  in  the  shape  of  acquired  defects. 

But  in  all  the  work  of  correlation  so  far  attempted,  one 
method  of  approach  has  been  almost  entirely  neglected.  I 
mean  the  method  of  experimental  introspective  psychology. 
To  be  sure,  we  see  that  the  correlations  of  Southard’s  work 
are  concerned  in  one  instance  with  the  great  sensory  field  of 
the  brain14  and  even  in  Jung’s  work  we  may  find  such 
isolated  statements  as  that  “the  origin  of  the  conception  of 
power  (Galileo)  is  to  be  sought  in  the  subjective  perception 
of  the  muscular  power  of  the  individual.”1’  But  no  general 
use  is  made  of  the  great  facts  which  may  be  determined  by 
introspection  and  of  the  general  reduction  to  elements  which 
may  be  accomplished  by  the  use  of  the  “action  theory”  as 
developed  by  Prof.  Miinsterberg,16  who  was,  perhaps,  the 
chief  exponent  of  the  introspective  method  during  the  past 
few  decades. 

Let  us  take  the  complex  phenomena  grouped  under  the 
term  “dementia  prsecox.”  Leaving  aside  the  physical  signs 
and  symptoms  and  dealing  only  with  the  mental,  we  have 
numerous  explanations  before  us  for  some  of  the  phenomena. 
These  have  been  reviewed  by  Jung1'  and  may  be  reduced  to 
theories  concerned  with  the  attention,  with  consciousness, 
with  associations,  with  affect,  with  apperception,  and  with 
activity.  But  all  these  may  be  reduced  in  the  light  of  the 
action  theory  to  elements  which  are  simpler,  either  sensa- 
tions from  the  special  sense  organs,  or  from  the  bones, 
muscles,  joints  and  other  sensory  surfaces.  This  reduction 
to  the  simplest  elements  is  the  hope  of  experimental  intro- 
spective psychology  and  this  reduction  is  essential  to  the 
obtaining  of  psychophysical  correlations.  But  in  the  insane 
patient,  the  reduction  can  only  be  made  by  a long  system  of 
analogies  and  these  must  often  be  based  on  the  behavior 
alone.  It  is  in  these  productions  of  the  patients  which  are 
irreducible  by  any  other  method  that  the  reduction  to 
elements  may  be  brought  about  by  the  use  of  the  psycho- 
analytic method;  this  granting  that  the  method  gives  true 
results  in  its  reductions.  The  methods  which  are  peculiar 
to  psycho-analysis  and  by  the  use  of  which  we  may  be 


322  Further  Application  of  the  Psycho- Analytic  Alethod 

aided  in  otherwise  obscure  correlations,  I take  to  be  the 
dream  analysis,  the  free  association  with  metonvmy  and 
elision,  the  analysis  of  jokes;  and  the  assumptions  I take 
to  be  the  theory  of  emotionally  conditioned  complexes,  the 
ego-complex,  the  unconscious,  the  phantasy,  the  “fixation,” 
the  resistances,  the  symbolism,  the  introversion,  the  projec- 
tion, the  transference  and  regressive  transference,  and  the 
theory  of  the  libido.  With  these  tools  we  may  expect  to 
arrive  at  certain  correlations  which  are  impossible  to  make 
with  the  direct  method  of  symptom  to  organ  or  with  the  facts 
and  elements  of  introspective  psychology  plus  the  action 
theory.  We  may  get  an  idea  as  to  the  inferior  organ  by 
using  the  tools  which  are  peculiar  to  psycho-analysis  where 
other  methods  fail. 

It  is  needless  to  say  that  the  ideas  here  expressed  are  still 
in  their  infancy  and  that  the  effort  to  carry  them  out  at  once 
would  be  fruitless  because  we  have  too  few  of  the  necessary 
tools  for  the  examination  of  the  brain  and  of  the  other  body 
organs.  For,  after  we  have  reduced  our  mental  symptoms 
to  the  visual,  taste,  touch,  smell,  auditory  and  kinesthetic 
components,  and  after  we  have  further  reduced  the  kines- 
thetic components  to  sexual  and  other  glandular  elements 
or  to  muscle,  joint,  and  other  serous  sensory  surface  elements, 
then  the  examination  of  the  physical  side  must  include  not 
only  the  structure  of  each  mechanistic  unit  from  the  external 
organ  through  the  centripetal  nerves  and  their  central  con- 
nections out  to  all  their  possible  connections  through  centri- 
fugal influences  but  it  must  also  include  all  the  possibilities 
on  the  chemical  and  physical  sides.  We  have  at  hand  now 
but  a single  instrument,  the  examination  of  the  microscopic 
section.  This  single  tool  has  yielded  a large  store  of  infor- 
mation about  individual  sections  and  where  large  numbers 
of  sections  from  an  organ  have  been  studied,  it  has  given  us 
a fair  idea  of  the  total  organ  but  it  is  inadequate  for  the  study 
of  such  a complex  organ  as  the  brain.  We  need  to  be  able 
to  cut  larger  areas  at  once  and  we  should  be  able  to  see  larger 
areas  in  the  same  microscopic  field. 

Turning  to  specific  cases,  we  find  that  the  use  of  the  Freu- 
dian mechanisms,  or  more  broadly,  of  the  psycho-analytic 
mechanisms,  is  unnecessary.  A case  in  point  is  that  cited 


II.  I.  Gosline 


323 


by  Dr.  Southard18  and  described  as  having  “combined  scenic 
hallucinations  of  a visual  nature.”  While  a specific  correla- 
tion between  these  hallucinations  and  changes  in  the  visuo- 
sensory  and  the  visuo-psychic  cortices  was  not  claimed,  yet  it 
might  well  be  stated  that  the  tissues  from  the  occipital  areas 
were  examined  with  especial  interest.  Similarly,  the  writer19 
can  cite  a case  of  paresis  with  catatonic  symptoms  in  which 
the  patient  was  at  first  very  loquacious  and  had  exaggerated 
ideas  of  his  ability  to  sing.  It  is  the  writer’s  contention  that 
these  two  symptoms  which  were  concerned  with  the  vocal 
apparatus,  were  conditioned  by  changes  in  the  vocal  apparatus 
or  in  its  central  connections  or  in  other  parts  of  the  economy 
which  are  able  to  affect  the  vocal  apparatus.  In  fact,  the 
chief  alterations  in  this  case,  which  was  studied  through  an 
exceptionally  large  number  of  sections,  were  found  in  the 
white  matter  of  the  post-Rolandic  areas,  the  areas  of  general 
sensibility.  I am  not  prepared  to  say  that  the  alterations 
in  the  areas  of  general  sensibility  were  such  as  to  give  the 
patient  a subjective  feeling  of  vocalizing  ability  which  then 
appeared  in  loquaciousness  and  profuse  singing,  but  I feel 
that  the  idea  warrants  farther  development. 

Turning  next  to  certain  cases  which  show  the  mechanisms 
claimed  by  psycho-analysis,  I have  selected  two  as  suitable 
to  point  out  the  way  in  which  the  psycho-analytic  method 
may  guide  the  anatomic  research.  The  first  is  a case  of  Dr. 
MacCurdy20  which  showed  a manic-like  state  illustrating 
Freudian  mechanisms  and  by  means  of  these  mechanisms 
many  of  the  productions  of  the  patient,  which  would  remain 
unintelligible  in  any  other  light,  and  have  to  be  neglected  in 
the  ordinary  psychiatric  examination,  were  made  intelligible 
and  reduced  to  elements.  If  such  a patient  were  to  come  to 
autopsy,  it  is  the  claim  of  this  paper  that  the  proper  direction 
for  study  in  his  case  would  be  the  apparatus  concerned  with 
the  elements  to  which  his  mental  productions  were  reduced. 
It  is  felt  that  we  might  logically  expect  more  from  such  a pro- 
cedure than  is  now  gained  by  a diffuse,  superficial  study  of 
many  parts  of  the  body,  which  is  the  procedure  now  followed 
for  want  of  a better  one.  And  not  only  at  the  autopsy 
should  this  method  give  us  aid  but  in  our  clinical  examina- 
tions the  analysis  should  direct  special  attention  to  the 


324  Further  Application  of  the  Psycho-Analytic  Method 


subserving  apparatus,  rather  than  to  the  diffuse,  superficial 
physical  examination  which  is  now  the  order. 

The  second  case  is  one  by  Dr.  Abbot21  which  illustrates  the 
mechanism  of  paranoia  and  reduces  it  to  the  mechanism  of 
prejudice.  This  mechanism  of  prejudice  is  concerned  with 
strongly  toned  affects,  in  the  case  mentioned  concerned  with 
the  amour-propre  and  certain  external  factors.  In  any  give 
case  of  prejudice,  it  was  pointed  out,  there  may  be  a “multi- 
plex mass  of  causes.”  These  causes,  it  appears  to  me,  may 
be  reduced  by  analogy  and  by  the  use  of  the  psycho-analytic 
mechanisms  to  further  elements  which  would  then  be  corre- 
latable  with  bodily  defects. 

In  closing,  I must  express  my  regret  at  not  having  been  able 
to  carry  out  the  ideas  here  expressed  into  the  pathological 
examination  of  patients  whose  psychosis  illustrated  psycho- 
analytic mechanisms.  The  result  is  that  these  ideas  can 
have  only  theoretical  interest  at  this  time.  But  I felt  that 
they  had  sufficient  logical  value  to  warrant  their  presentation 
at  this  meeting. 

'Cushing,  Harvey  and  Goetsch,  Emil — Hibernation  and  the  Pituitary  Body — 
J.  Expt.  Med.  XXII.  1,  July,  1915. 

2Gosline,  H.  I.  A Contribution  to  the  Symptom  Complex  Associated  with 
Interpeduncular  Tumors.  J.  Nerv.  and  Ment.  Dis.,  vol.  45,  No.  4,  p.  337. 

?Quoted  in  White,  Wm.  A.  Mechanisms  of  Character  Formation.  Mac- 
Millan, New  York,  1916. 

4Jung,  C.  G.  Analytical  Psychology,  1916. 

5Miinsterberg,  Hugo.  Psychology  General  and  Applied.  Appleton,  New 
York,  1914. 

6Jung,  C.  G.  Loc.  cit. 

7White,  Wm.  A.  Loc.  cit. 

8Jung,  C.  G.  Uber  die  Psychologie  der  Dementia  Praecox,  1907.  Jung,  C.  G. 
The  psychology  of  the  Unconscious,  1916. 

9 Southard,  E.  E.  On  the  Somatic  Sources  of  Somatic  Delusions.  J.  Abn. 
Psychol.  Dec.,  1912-Jan.,  1913. 

10Gos!ine  H.  I.  The  Conduct  of  the  Insane:  A Contribution  to  Psycho- 
pathological  Theory.  Presented  at  the  Twentieth  Anniversary  of  the  Founding  of 
the  Danvers  State  Hospital  Laboratory,  1915. 

"Freud,  Sigmund.  Papers  on  Hysteria. 

"Jung,  C.  G.  Loc.  cit. 

1 3 Adler,  Alfred.  Study  of  Organ  Inferiority  and  Its  Psychical  Compensation. 
Nerv.  and  Ment.  Dis.  Publ.  Co.,  New  York,  1917. 

1 4Southard,  E.  E.  On  the  Topographical  Distribution  of  Cortex  Lesions  and 
Anomalies  in  Dementia  Praecox,  with  Some  Account  of  Their  Functional  Signi- 
c ance.  Massachusetts  State  Board  of  Insanity  No.  23,  (1914-5). 

"Jung,  C.  G.  Psychology  of  the  Unconscious. 

1 6Miinsterberg,  Hugo.  Loc.  cit.  and  in  various  writings. 

1 7Jung,  C.  G.  Psychology  of  Dementia  Praecox.-  Loc.  cit. 

"Southard,  E.  E.  On  the  Direction  of  Research  as  to  the  Analysis  of  Cortical 


H.  I.  Gosline 


325 


Stigmata  and  Focal  Lesions  in  Certain  Psychoses.  Transactions  of  the  Assn,  of 
American  Physicians,  XXIX,  1914. 

19Gosline,  H.  I.  Paresis  or  Dementia  Praecox?  Read  at  Conference  on 
Neurosyphilis  at  the  Grafton  State  Hospital,  Worcester,  Mass.,  Nov.  1916. 

S0MacCurdy,  John  T.  The  Productions  in  Manic-Like  State  Illustrating 
Freudian  Mechanisms.  J.  Abn.  Psychol.  Feb.-March,  1914. 

21  Abbot,  E.  Stanley.  The  Mechanism  of  Paranoia.  J.  Nerv.  and  Ment.  Dis. 
Vol.  45,  No.  4,  p.  312. 


THE  TREATMENT  OF  DEMENTIA  PRAECOX  BY 
PSYCHOANALYSIS1 

A Preliminary  Report. 

BY  ISADOR  H.  CORIAT,  M.D. 

First  Assistant  Visiting  Physician  for  Diseases  of  the  Nervous 
System , Boston  City  Hospital. 

IN  spite  of  the  fact  that  dementia  praecox  is  so  widespread 
a disease  and  leads  to  such  severe  grades  of  mental  dis- 
integration, very  little  has  been  attempted  in  the  way  of 
treatment  except  hospital  residence  or  along  symptom- 
atic lines.  A radical  therapy  of  the  disorder,  that  is,  an  at- 
tack on  the  fundamental  characteristics  of  the  disease,  has 
been  possible  only  with  the  development  of  psycho-analysis. 
The  following  preliminary  report  is  based  upon  the  psycho- 
analytic treatment  of  five  cases  of  dementia  praecox,  a more 
complete  discussion  being  reserved  for  a future  publication. 
To  most  psychiatrists  in  fact,  the  diagnosis  of  dementia 
praecox  has  been  synonymous  with  hopelessness,  the  same 
attitude  as  was  taken  towards  another  severe  brain  disease, 
paresis,  before  the  treatment  with  salvarsanized  serum,  either 
along  the  intradural  or  intraventricular  routes  was  instituted. 
Various  attempts  at  the  cure  of  dementia  praecox  have  been 
made  along  the  lines  of  immunology  or  even  of  extirpation  of 
the  ductless  glands  (thyroid)  but  none  of  these  have  yielded 
any  definite  results.  In  fact  Kraepelin  and  even  Bleuler 
devote  but  little  space  to  the  treatment  of  the  disease 
although  the  latter  emphasizes  that  the  therapy  must  be 
directed  along  purely  psychogenetic  lines.  If,  however,  we 
agree  with  Adolf  Meyer,  that  many  cases  of  dementia  praecox 
tend  to  develop  on  the  basis  of  an  abnormal  personality, 
much  can  be  done  to  prevent  the  disease  in  children  by  strongly 
combatting  any  shut-in  tendencies  they  may  manifest. 

iRead  before  the  Eighth  Annual  Meeting  of  the  American  Psychopatho- 
logical  Association  at  Boston,  Mass.,  May  24,  1917. 

326 


Isador  //.  Coriat 


327 


The  only  hope  of  combatting  the  disease  must  be  based 
upon  the  conception  of  interpreting  it  purely  as  a psycho- 
genetic  disorder  afe  Bleuler  has  done2  a sort  of  a with- 
drawal from  reality  (autism)  in  a mind  dominated  by  re- 
pressed and  unconscious  ideas  and  emotions,  in  much  the  same 
way  as  we  interpret  hysteria,  but  in  a more  intense  and  less 
accessible  form.  In  fact,  the  interpretation  of  schizophrenic 
negativism  and  stupor  on  a psychogenetic  basis,  as  a form 
of  withdrawal  from  reality,  rather  than  as  a disorder  of  the 
central  convolutions  or  of  cerebral  torpor,  is  in  harmony  with 
the  recent  advances  in  the  etiology  of  dementia  praecox. 

Dementia  praecox  thus  not  only  resembles  a psycho- 
neurosis, but  at  the  same  time  it  may  have  symptoms 
resembling,  although  only  superficially,  an  organic  disease, 
such  as  the  muscular  negativism,  the  myxcedematous  thick- 
ening of  the  skin,  epileptiform  episodes,  vasomotor  disorders, 
etc.  The  withdrawal  from  reality  best  explains  the  stupors 
and  the  emotional  deterioration.  Dementia  praecox  is  a 
reaction  to  a mental  conflict,  resulting  in  a withdrawal  from 
reality  and  a profound  dissociation  of  the  consciousness. 
Many  of  the  conflicts  are  deep  seated,  others  superficial  and 
it  is  upon  these  characteristics  that  their  amenability  to 
psycho-analysis  depends. 

However,  the  recent  investigations  on  the  nature  of  demen- 
tia praecox  show  that  a great  deal  may  be  expected  from 
treatment  based  on  psychological  principles,  in  the  sense  of 
readjustment  and  re-education,  an  analysis  of  the  symptoms 
and  finally  a thorough  psycho-analysis  of  the  entire  content 
of  the  psychosis.  Psycho-analysis  may  cure  the  mild  or 
early  cases  of  dementia  praecox,  while  in  the  more  severe 
types,  the  analysis  may  relieve  the  synpptoms  to  a certain 
extent  or  may  provide  useful  hints  to  intelligently  readjust 
and  regulate  the  life  interests  of  the  patient.  I feel  that 
every  case  of  dementia  praecox  especially  the  mild  cases  or 
in  the  early  stages,  should  be  given  the  benefit  of  a psycho- 
analysis. 

A study  of  the  spontaneous  process  of  recovery  in  dementia 
praecox  furnishes  information  as  to  the  nature  of  the  conflict 

2Bleuler  E.  Dementia  Praecox  oder  Gruppe  der  Schizophrenien,  1911. 


328  Treatment  of  Dementia  Praecox  by  Psychoanalysis 

and  the  manner  of  readjustment  and  thus  points  the  way  for 
an  intelligent  and  well-directed  psycho-analysis.  Bert- 
schinger'5  in  a most  admirable  and  illuminating  manner,  has 
pointed  out  the  various  ways  of  getting  well  in  dementia 
praecox.  According  to  him,  there  are  three  types  of  spontane- 
ous readjustment,  i,  e.,  correction  of  the  delusions,  resymbol- 
ization and  evasion  of  the  complex.  These  are  spontaneous 
mechanisms.  In  addition,  as  a result  of  treatment  of 
dementia  praecox  with  psycho-analysis,  I would  add  a fourth 
mechanism  of  recovery,  as  showing  the  effect  of  psycho- 
analysis on  the  fundamental  basis  of  the  disease.  This 
fourth  manner  of  readjustment,  which  is  brought  about  by 
psycho-analysis  and  which  is  the  most  important  of  all,  may 
be  termed,  the  return  to  reality.  When  we  consider,  accord- 
ing to  Zablocka’s  statistics,4  that  out  of  515  cases  of  de- 
mentia praecox  60%  preceded  to  light,  18%  to  medium  and 
22%  to  severe  deterioration,  it  seems  worth  while  to  attempt 
treatment  at  the  psychological  level,  even  if  this  treatment 
merely  ameliorates  and  does  not  cure  the  condition. 

The  best  method  of  psychological  treatment  I consider  to 
be  psycho-analysis.  I have  utilized  this  form  of  treatment  in 
5 cases  of  dementia  praecox  of  varying  intensity  and  dura- 
tion and  it  is  the  purpose  of  this  paper  to  briefly  report 
these  cases  and  the  results  attained.  Psycho-analysis  reveals 
the  nature  of  the  conflicts  in  dementia  praecox  and  the 
causes  for  the  withdrawal  from  reality.  It  does  not  pretend 
to  have  discovered  the  inner  nature  of  the  disease  process  or 
the  causes  for  individual  symptoms,  although  the  psycho- 
analytic viewpoint  has  thrown  considerable  light  upon  the 
nature  of  schizophrenic  negativism.  As  it  is  impossible  to 
report  these  psycho-analyses  in  detail,  only  a brief  outline 
of  each  case  with  certain  of  the  essential  features,  will  be 
given. 

Briefly,  the  results  in  the  five  cases  which  were  subjected 
to  psycho-analysis,  may  be  summarized  as  follows: 

In  the  first  case,  a young  man  of  26,  the  schizophrenic 

3Bertschinger,  H.  Heilungsvorgange  bei  Schizophrenen,  Allg.  Zeit.  f.  Psv- 
chiatrie  Bd.  LXVIII,  H.  2,  1911. 

4Zabloka  Zur  Prognosestellong  bci  der  Dementia  Praecox,  Allg,  Zeit  f.  Psychia- 
tric, Bd  LX\  . 


Isador  H.  Coriat 


329 


introversion  began  at  about  puberty,  when  the  most  manifest 
symptoms  were  the  development  of  a homosexual  trend  and 
complete  loss  of  all  initiative  and  ambition.  After  several 
months  of  psycho-analysis  the  condition  improved  to  a cer- 
tain extent,  although  the  homosexual  trend  and  the  shut-in 
personality  persisted  to  a certain  degree. 

The  second  case,  a young  woman  of  29,  began  to  show, 
three  years  before  coming  under  treatment,  a typical  schizo- 
phrenic negativism  with  outbursts  of  causeless  laughter  and 
feelings  of  passivity  and  telepathic  influence.  She  recovered 
after  two  months’  psycho-analytic  treatment  and  had  re- 
mained well  three  years  later.  An  interesting  feature  in 
this  case,  was  the  fact  that  it  was  possible  through  psycho- 
analysis to  trace  the  origin  of  her  ideas  of  telepathic  influence. 
Because  certain  sexual  wish  fantasies  were  incompatible  with 
her  personality  and  their  origin  not  understood,  since  they 
sprung  from  childhood  ideas  which  had  been  repressed  into 
the  unconscious,  an  explanation  of  telepathic  influence  was 
invented  by  the  patient  as  sort  of  a defense  reaction  to 
explain  the  origin  of  her  unconscious  and,  therefore,  unknown 
thoughts.  Through  a sort  of  a transference,  she  projected 
these  thoughts  to  certain  persons  of  the  opposite  sex.  Her 
negativistic  reactions  also,  arose  from  an  effort  to  repel  her 
sexual  thoughts,  for  instance,  she  would  constantly  avoid  and 
shun  the  appearance  of  men  by  bowing  her  head  and  closing 
her  eyes.  She  found  it  easier  to  shut  the  eyes  than  to  keep 
them  open,  in  fact,  after  she  was  well,  she  admitted  that  it 
was  an  effort  to  keep  the  eyes  open.  The  negativism  is 
interesting  since  it  harmonizes  with  Bleuler’s  view  of  the 
mental  mechanism  of  negativistic  phenomena.  He  states  for 
instance:0  “That  the  negativistic  repelling  very  often  means 
the  outspoken  stamp  of  the  erotic  must  be  due  to  a root  of 
the  negativism  being  in  the  sexuality.  The  sexuality  has 
normally  a strong  negativistic  component,  it  shows  itself 
clearest  in  the  opposition  of  the  female  against  the  sexual 
approach.  We  know  that  there  is  no  case  of  schizophrenia 
in  whose  complexes  sexuality  does  not  play  a prominent  role 
and  very  often  the  repelling  is  found  in  sexual  delusions.” 

5 Bleuler,  E.  The  Theory  of  Schizophenic  Negativism,  19 1 2. 


330  Treatment  of  Dementia  Praecox  by  Psychoanalysis 

The  third  case  was  a young  woman  of  18,  who  for 
several  years  had  shown  decreased  emotionalism  and  more 
and  more  of  a shut-in  tendency.  Although  externally  she 
was  antisocial  and  negativistic,  yet  her  inner  fantasies 
were  quite  elaborate,  particularly  along  the  line  of  erotic 
wishes  to  attract  men,  which  took  the  form  of  what  may  be 
termed  a Lorelei  complex.  This  complex  was  particularly 
manifested  in  certain  curious  dreams  as  a form  of  erotic 
symbolism  in  which  she  appeared  with  red  hair  for  the  pur- 
pose of  attracting  the  opposite  sex,  since  she  always  inter- 
preted the  “goldenes  Haar”  of  Heine’s  poem,  as  meaning 
“golden  red.”  After  three  months  of  psycho-analytic 
treatment  the  shut-in  tendencies  completely  disappeared 
and  the  social  reactions  became  normal. 

The  fourth  case,  a young  woman  of  33,  who  for  16  years 
had  shown  increasing  irritability  and  introversion.  Improved 
after  two  months  of  psycho-analytic  treatment. 

In  the  fifth  case,  a young  man  of  17,  for  years  had  been 
queer,  odd  and  peculiar,  had  shown  a marked  mother  attach- 
ment and  many  infantile  reactions  in  his  behavior.  The 
dreams  were  all  at  the  infantile  level,  that  is,  simple  literal 
and  non-elaborated  wish  fulfillments,  such  as  might  occur  in 
a child  of  five.  This  patient  is  still  under  treatment,  but  has 
shown  some  improvement  in  his  reactions,  while  the  dream 
have  become  more  elaborated  and  somewhat  symbolized,  in 
fact,  they  are  slowly  rising  to  the  adolescent  level.  A com- 
plete recovery  in  this  case  is  impossible,  however,  even  though 
the  changes  in  the  dreams  show  an  improvement  in  the  uncon- 
scious, since  here  we  are  dealing  with  a fundamental  defect 
in  the  mental  makeup. 

In  all  these  cases,  the  schizophrenic  dissociation  was  quite 
marked.  The  beneficial  results  of  treatment  lead  me  to  be- 
lieve as  stated  before,  that  certain  well-selected  cases  of 
dementia  praecox  should  be  given  the  benefit  of  a psycho 
analysis.  According  to  my  experience,  the  first  sign  of 
improvement  in  dementia  praecox  under  the  psycho-analytic 
treatment  is  a change  in  the  nature  of  the  dreams,  they  slow- 
ly become  less  primitive  and  infantile.  Then  follows  a change 
in  the  social  reaction  of  the  patient,  that  is,  a diminution  of 
the  autistic  and  negativistic  tendencies. 


HOW  FAR  CAN  IDEAS  DIRECTLY  INFLUENCE 
OR  AFFECT  PERIPHERAL  PROCESSES? 

by  meyer  Solomon,  m.  d.,  Chicago. 

THE  question  which  I have  asked  myself  in  the  title 
of  this  paper  is  one  which  has  come  to  my  lips  very 
often  in  the  course  of  my  work  in  psychopathology 
and,  especially,  when  reading  the  literature  with 
reports  of  cases,  especially  where  interpretation  of  the 
origin  and  nature  of  the  symptoms  present  has  been  at- 
tempted by  the  author. 

Frequently,  in  speaking  of  conditions  psychogenetically 
produced,  we  do  not  differentiate  between  those  of  ideoge- 
netic  origination  and  those  of  emotogenetic  source.  In  other 
words,  we  are  too  apt  to  overlook  the  essential  difference 
between  the  more  purely  isolated  ideational  process  which  is 
not  charged  with  the  impulsive  force  and  explosiveness  that 
we  find  in  true  emotions  with  their  bodily  reactions  It  is, 
of  course,  to  these  bodily  changes  that  William  James  refer- 
red1 when  he  gave  his  theory  of  the  emotions  which  he  be- 
lieved applied  to  the  coarser  emotions  at  least,  in  these 
words:  “My  theory,  on  the  contrary,  is  that  the  bodily 
changes  follow  directly  the  perception  of  the  exciting  fact , and 
that  our  feeling  of  the  same  changes  IS  the  emotion.”  (Italics 
James’) 

The  possible  direct  bodily  effects  of  ideas  should  be 
found  to  be  expressed  by  those  who  have  studied  dreams, 
hypnotism,  the  disordered  states  of  mind,  and  the  possible 
effects  of  suggestion  and  simulation. 

So  far  as  I can  learn,  no  one  believes  that  the  mere  flow 
of  ideas  as  it  occurs  in  some  dreams,  without  the  stirring  up 
of  the  emotions,  can  produce  any  of  the  types  of  peripheral 
changes  which  I shall  discuss  under  the  subject  of  the 
supposed  effects  of  hypnotism. 

The  effects  of  simulation,  it  will  be  granted  at  once,  can 


331 


332  How  Far  Can  Ideas  Influence  Peripheral  Processes 

be  no  different  from  those  of  ordinary  suggestion  in  the  wak- 
ing state  in  the  average  person.  And  the  possible  effects 
of  suggestion  in  the  waking  state  of  most  of  us,  cannot 
possibly  be  any  greater  than  its  effects  as  found  in  hypnosis. 

Likewise,  what  we  have  to  say  about  the  possible  effects 
of  hypnosis,  has  direct  application  to  the  question  of  the  role 
of  ideas  in  disordered  mental  states  in  the  production  of 
peripheral  processes. 

To  plunge  at  once,  then,  into  the  depths  of  the  problem, 
let  us  see  what  confronts  us  when  Ave  stand  face  to  face  with 
the  problem  of  hypnotism  and  its  possible  bodily  or  peripher- 
al effects. 

THE  POSSIBLE  PERIPHERAL  CHANGES  PRODLTCIBLF. 

BY  HYPNOTISM. 

One  of  the  best  recent  works,  for  the  purposes  of  my 
discussion,  which  I find  of  value,  is  that  entitled  “Treatment 
by  Hypnotism  and  Suggestion  or  Psychotherapeutics”  by 
C.  Lloyd  Tuckey,  1907. 

Tuckey  has  compiled  the  possible  effects  which  have 
been  reported  by  competent  persons. 

On  page  74  of  this  work  he  informs  us  that  a patient  in 
hypnotic  sleep  as  a result  of  suggestion  not  only  feels  heat 
and  pain  in  the  place  which  is  touched  by  the  operator  and 
in  which  he  is  told  he  has  been  burnt,  but,  further  than  this, 
the  “spot  becomes  red  and  inflamed,  exhibiting  all  the  ob- 
jective signs  of  congestion,  and  even  of  inflammation, 
vesication,  etc.  The  suggestion  of  the  operator  has,  through 
the  patient’s  imagination,  been  able  to  effect  thevasomotor 
functions  of  the  sympathetic  nervous  system.  ” He  rightly 
adds  that  if  suggestion  can  produce  such  local  conditions, 
“it  can  also  dissipate  and  cure  these  conditions  when  they 
occur  in  disease.  ” 

He  recites  the  experiments  of  Delboeuf  who,  “desiring 
to  ascertain  the  positive  effect  of  hypnotic  suggestion  in  the 
treatment  of  a burn,  and  being,  of  course,  unable  to  find  two 
persons  of  identical  constitution  and  condition  generally, 
used  the  ingenious  device  of  producing,  with  caustic,  two 
exactly  similar  burns  on  the  same  person — one  on  each  arm — 


Meyer  Solomon 


333 


and  of  treating  one  wound  by  curative  suggestion,  combined 
with  the  usual  remedies,  and  the  other  with  the  usual  rem- 
edies only.  Having  induced  hypnotic  sleep,  he  suggested 
to  the  patient  that  the  one  arm  should  be  cured  painlessly 
and  without  any  suppuration;  and  it  did  in  fact  heal,  by 
simple  separation  of  the  slough  and  healthy  granulation  ten 
days  earlier  than  the  other  which  went  through  the  suppura- 
tive process,  accompanied  by  inflammation  and  pain.  Were 
this  case  not  reported  by  a well-known  savant,  I confess  I 
should  feel  some  hesitation  in  recording  it  here;  as  it  is,  its 
accuracy  is  beyond  doubt.”  But,  to  be  sure,  I may  add, 
no  evidence  is  here  offered  that  the  suggestion  had  anything 
to  do  with  the  healing  in  the  manner  described. 

On  page  20  Tuckey  tells  us  of  the  cure  of  warts  by 
suggestion:  “Many  physicians  testified  (at  a meeting  of  the 
Societe  d’Hypnologie  et  de  Psychologie  in  June,  1902)  to 
having  seen  charms  succeed  in  some  cases  and  fail  in  others, 
and  Dr.  Farez  showed  a series  of  photographs  taken  of  a 
girl’s  hand  he  had  cured  by  hypnotic  suggestion  after  charms 
had  failed.  Dr.  Berrillon  stated  that  to  test  the  discrimina- 
ting powers  of  suggestion  he  had  in  a very  bad  case  treated 
only  one  hand,  and  that  this  was  speedily  cleared  of  warts, 
while  the  other  remained  disfigured  until  he  applied  hypnotic 
suggestion  to  that  also.”  And  in  a footnote  on  the  same 
page  he  adds:  “A  prominent  member  of  the  Society  for 
Psychical  Research,  Miss  Mason,  has  reported  several  cases 
of  cures  she  has  affected  by  simple  suggestion,  and  she  tells 
me  she  generally  succeeds,  especially  with  children.  She 
just  touches  each  wart  with  her  finger  and  says  ‘Go  away,’ 
and  by  her  next  visit  she  finds  they  have  shrivelled  up  and 
disappeared.  Miss  Afason  holds  an  important  Government 
inspectorship,  so  her  dignified  position  no  doubt  impresses 
the  small  patient.  It  is  stated  that  the  more  vascular  a wart 
is,  as  shown  by  its  readiness  to  bleed,  the  more  likely  is  it  to 
respond  the  suggestion.  ” 

On  page  75  Tuckey  quotes  Beaunis  as  having  reported 
a case  in  which,  by  suggestion,  he  regulated  the  pulse  of  a 
patient.  “He  also  succeeded  in  slightly  raising  the  tempera- 
ture qf  patients  by  suggesting  an  increase  of  warmth.  ” 
In  this  case,  apparently,  even  if  the  conclusions  could  have 


334  How  Far  Can  Ideas  Influence  Peripheral  Processes 

been  scientifically  proven  to  be  true,  the  possible  inter- 
vention of  the  emotions  as  the  result  of  ideational  influences 
does  not  seem  to  have  been  sufficiently  considered. 

Tuckey  is  quick  to  admit,  however,  farther  along  on  the 
same  page,  that  “the  subjects  on  whom  vesication  can  be 
produced  by  suggestion  are,  I imagine,  very  few  and  in  them 
probably  only  after  prolonged  experimentation.” 

I may  complete  the  list  of  peripheral  changes  producible 
by  suggestion  as  given  by  Tuckey  by  giving  a few  more 
quotations: 

“Beaunis  describes  at  some  length  the  production  of 
all  the  effects  of  a blister  following  the  suggestion  that  one 
had  been  applied”  and  he  gives  the  experiments  performed. 

“Dr.  Wetterstrand  has  kindly  sent  me  photograph  of 
a woman’s  hand,  on  which  he  raised  blisters  by  simply  touch- 
ing places  with  the  tip  of  his  finger  and  suggesting  it  was  a 
hot  iron.  The  converse  experiment  has  also  proved  success- 
ful. A blister  is  applied  to  a hypnotized  subject  who  is  told 
that  it  is  a soothing  liniment,  and  no  vesication  is  produced 
(Alfred  Fouillee,  Rev.  des  Deux  Mondes,  May,  1891).” 

“Professor  Bourru  and  Burot,  of  Rochefort,  succeeded 
in  causing  hemorrhage  from  the  nose,  by  suggesting  that 
it  should  take  place,  in  a young  soldier  of  epileptic  and 
hysterical  constitution;  they  even  fixed  the  hour  when  it 
should  come.  On  this  same  subject,  Dr.  Mabille,  of  the 
lunatic  asylum  at  Lafond,  produced  instantaneously,  by 
suggestion,  hemorrhage  from  different  parts  of  the  body, 
exactly  similar  in  character  to  the  stigmata  of  some  medieval 
saints.”  Although  one  does  not  like  to  question  these 
findings,  still,  it  does  remind  one  very  much  of  some  of  the 
declarations  made  by  the  late  Mrs.  Eddy  and  her  followers 
on  the  power  of  the  mind  over  the  body. 

Tuckey  cites  Krafft-Ebing  who,  in  his  monograph  on 
the  case  of  lima  Szander,  a young  Hungarian  girl  of  ex- 
tremely hysteric  type,  reports  that  he  was  able  by  simple 
suggestion  to  produce  blisters  and  hemorrhages  and  to  effect 
marked  alterations  in  temperature  and  in  the  character  of 
the  pulse  and  respiration” — even  in  lowering  of  the  tempera- 
ture at  a fixed  hour. 

He  refers  to  Binet  and  Fere’s  Animal  Magnetism,  1887, 


Meyer  Solomon 


335 


who  tell  how  “Bourru  and  Burot  wrote  a name  with  the 
blunt  end  of  a probe  on  both  arms  of  a hysterical  patient, 
suggesting  to  him  ‘This  afternoon,  at  four  o’clock,  you  will 
go  to  sleep,  and  blood  will  then  exude  from  your  arms  in  the 
lines  which  have  been  traced.’  The  patient  fell  asleep  at 
the  appointed  hour,  and  the  letters  appeared  on  his  left  arm, 
marked  in  relief,  and  of  a bright  red  color,  with  here  and 
there  minute  drops  of  blood.  But  no  such  sign  appeared  on 
the  right  arm  which  was  paralyzed.  ” 

Once  more,  taking  his  information  from  Binet  and  Fere, 
he  tells  us  that  “Charcot  . . . and  his  pupils  at  the 

Salpeterire  have  often,  by  means  of  suggestion,  produced  the 
effects  of  burns  upon  the  skin  of  hypnotized  patients.  Fere 
adds  that  he  has  demonstrated  that  any  part  of  the  body  of  a 
hysterical  patient  may  be  made  to  change  in  volume  by 
simple  directed  attention,  thus  showing  what  influence  may 
be  exerted  by  a simple  phenomenon  of  ideation  on  the 
vasomotor  centres.” 

Alfred  T.  Schofield,  in  “Unconscious  Therapeutics  or 
the  Personality  of  the  Physician,”  1906,  page  34,  states: 
“Dr.  Lloyd  Tuckey  remarks  (Hypnotism  and  Suggestion, 
4th  edition,  page  11),  not  without  reason,  that  the  action  of 
the  mind  may  explain  the  numerous  cases  where  medical  men 
have  fallen  victims  to  diseases  of  the  organ  which  has  been 
their  especial  study,  as  Trousseau  died  of  cancer  of  the 
stomach,  etc.” 

Any  number  of  writers  have  told  of  the  hallucinatory 
phenomena  which  they  believed  occurred  as  a result  of 
hypnotic  suggestions — visual  hallucinations,  auditory  hallu- 
cinations, etc. 

Allied  to  these  views  we  may  mention  the  superstitious 
belief,  common  among  the  laity,  in  the  effects  of  marking 
or  maternal  impressions,  as  the  result  of  mere  ideas  as  well 
as  fright,  shock  and  trauma. 

In  contrast  to  the  statements  above,  let  us  listen  to 
George  W.  Jacoby,  who  in  his  “Suggestion  and  Psycho- 
therapy,” 1912,  page  150,  says:  “Bodily  functions  may  be 
affected  by  means  of  suggestion,  though  organic  changes 
cannot  be  brought  about.”  In  discussing  Krafft-Ebing’s 
and  Forel’s  experiments  to  ascertain  whether  organic  change 


336  How  Far  Can  Ideas  Influence  leripheral  Processes 

can  possibly  be  produced  by  suggestion,  he  declares: 
“ . . . even  assuming  the  deception  in  each  case  was  a 

complete  success  and  that  the  effects  logically  to  be  expected 
ensued,  and  ignoring  the  fact  that,  when  they  were  successful, 
(they)  had  to  be  most  skeptically  received,  the  result  does 
not  by  any  means  overthrow  the  rule  that  organic  changes 
cannot  be  produced  by  suggestion  alone.  In  our  opinion  it 
is  an  ample  explanation  in  these  instances  to  say  that  it  was 
hyperemia  due  to  suggestion,  and,  therefore,  a functional 
change  in  the  circulation  of  the  blood  which  caused  the 
hemorrhages  and  the  alterations  in  the  skin.”  But  even 
with  his  explanation,  it  is  plain  that  he  would  postulate 
that  suggestion  can  cause  changes  in  the  involuntary  ner- 
vous system,  although  he  does  not  differentiate  between 
genuine  ideation  and  ideation  or  suggestion  which  is  accom- 
panied by  emotionalism. 

I cannot  enter  into  an  analytic  or  critical  discussion 
of  the  assertions  which  I have  here  enumerated.  It  is 
enough  to  say  that  the  reports  of  such  results  taking  place 
in  the  peripheral  processes  as  a result  of  suggestion  are  so 
few  and  far  between,  the  positive  proof  that  .the  results 
observed  were  unquestionably  the  direct  result  of  suggestion 
is  so  frequently  lacking,  the  marvels  reported  are  so  far 
beyond  the  facts  of  ordinary,  everyday  life  as  we  know  it, 
it  seems  so  impossible  to  reproduce  these  reported  wonders 
of  hypnotism,  and  the  whole  business  seems  so  shrouded  in 
mystery  to  most  of  us,  that,  unless  thoroughly  convincing 
evidence  is  forthcoming,  so  that  no  flaws  can  be  found  in 
the  reports  and  they  can  be  reproduced  with  positiveness  by 
different  experimenters  of  standing,  we  may  well  question 
the  truth  of  the  conclusions  arrived  at,  although  the  observa- 
tions may  have  been  correct. 

CLAIMS  MADE  IN  CLINICAL  PSYCHOPATHOLOGY 

Aside  from  what  has  been  given  of  the  claims  made  for 
hypnotism,  we  find  certain  declarations  in  this  connection  in 
clinical  psychopathology. 

Without  giving  the  views  of  the  different  writers  and 
students  in  this  field,  I may  say  that  here,  too,  a sharp 


Meyer  Solo?no?i 


337 


difference  has  not  always  been  made  between  the  effects  of 
emotion  and  those  of  ideation.  As  a consequence,  much  of 
what  one  reads  about  the  influence  of  the  mind  on  the  body 
is  confusing.  This  is  especially  so  in  reading  the  sympto- 
matology of  socalled  hysteria.  So  confusing  was  this  to  me, 
that  I found  myself  compelled  to  write  a paper  recently 
entitled  “On  the  Use  of  the  Term  ‘ Hysteria  ’ with  a Plea  for  its 
Abolition  and  a Consideration  of  the  Problem  of  Dismember- 
ment of  So-called  Hysteria.”2  Under  the  term  hysteria  we 
have  had  included  by  different  writers  conditions 
of  many  kinds— lying,  simulation,  suggestionism  (which 
Babinski  would  call  “pithiatism”),  self-mutilations  (which 
Dupre  would  label  “mythomania”),  the  transient  effects 
of  acute  emotionalism,  and  the  more  or  less  protracted  and 
post-emotional  disorders  which  we  find  most  characteristical- 
ly in  that  condition  which  has  been  described  as  post- 
traumatic  hysteria. 

Hence  all  kinds  of  disordered  functioning  of  the  volun- 
tary and  involuntary  nervous  systems  have  been  attributed 
to  socalled  hysteria,  without,  in  too  many  cases,  specifically 
defining  in  what  sense  this  term  was  being  employed.  Here 
we  may  find  paralyses,  pareses,  contractures,  tremors, 
choreiform  movements;  anesthesias,  paresthesias,  hyperes- 
thesias; pains  have  been  included  by  rqany;  disordered  func- 
tioning of  the  special  senses — vision,  hearing,  taste,  smell, 
etc.,  generally  in  the  direction  of  lowered  functioning  or 
lessened  activity;  but  in  other  cases  over-activity  and  in- 
voluntary functioning  of  these  functions  have  been  des- 
scribed,  with  hallucinations  of  smell,  of  vision,  and  the  like, 
and  with  hallucinations  referred  to  the  skin,  such  as  feelings 
of  coldness,  of  warmth,  crawling  sensations,  and  so  forth. 

Further  than  this  we  find  many  including  such  low-level 
nervous  system  disorders  as  vasomotor,  secretory  and  trophic 
disturbances,  so  that  there  may  be  enumerated  hyperemia, 
congestion,  erythema,  gangrene,  ulcers,  pruritis,  urticaria, 
psoriasis,  etc. 

The  failure  to  differentiate  between  the  various  types  of 
conditions  mentioned  above — simulation,  lying,  self-mutila- 
tions, suggestionism,  and  the  transient  and  protracted 
phenomena  flowing  out  of  emotional  upset,  plus  errors  in 


338  How  Far  Can  Ideas  Influence  Peripheral  Processes 

diagnosis,  have  been  responsible  for  the  inclusion  of  so  manv 
conditions  under  this  heading. 

The  recent  efforts  to  explain  some  of  these  vegetative 
nervous  system  manifestations  occurring  in  patients  who  at 
the  same  time  happened  to  be  suffering  from  definite  idea- 
tional disorders,  as  the  symbols  of  mental  conflict,  with  con- 
version, by  repression  into  the  subconscious,  of  painful 
mental  states  into  peripheral  reactions,  seems  to  be  based 
upon  the  assumption  of  the  truth  of  the  report  in  which 
similar  manifestations  were  laid  at  the  door  of  the  psycho- 
neuroses, without  any  attempt  to  differentiate  between 
ideationally  and  emotionally  induced  phenomena. 

The  error  of  this  viewpoint,  will,  I believe,  be  cleared  up 
in  the  course  of  the  remainder  of  this  paper. 

I must,  however,  say  at  once  that  Babinski3  took  a 
great  step  forward  in  the  proper  direction  when  he  attempted 
to  dismember  the  hysteria  of  tradition. 

He  called  attention  to  the  phenomena  due  to  simulation, 
suggestion  (his  “pithiatism”),  self-mutilation,  emotionalism 
and  of  a reflex  nature  respectively.  His  “pithiatism”  is 
nothing  more  than  a sort  of  blind  simulation  in  which  the 
phenomena  are  produced  by  suggestion  (the  acceptance  of 
unreasonable  ideas)  and  cured  by  persuasion  (the  acceptance 
of  reasonable  ideas.)  Although  we  may  not  agree  with  him 
in  his  claims,  in  some  respects,  as  to  the  power  of  suggestion 
in  causing  the  protracted  symptoms  of  the  kind  found  in 
socalled  post-traumatic  hysteria,  still  we  cannot  help  agreeing 
with  him  when  he  insists  that  ideas  or  pure  suggestions 
cannot  of  themselves,  and  in  direct  manner,  produce  dis- 
orders of  a vasomotor,  secretory  or  trophic  nature,  hem- 
orrhages, anuria,  albuminuria  and  fever.  He  adds  that 
ideas  or  suggestion  cannot  abolish  or  exaggerate  the  true 
tendon  reflexes — although,  it  should  be  remarked,  one  can, 
by  ideational  or  voluntary  intervention,  interfere  with  the 
reflex  response  by  assisting  or  inhibiting  the  reflex  reaction; 
nor  can  one  thus  cause  changes  in  the  pupillary  or  skin  re- 
flexes. He  is  willing  to  agree  that  suggestion  is  capable  of 
producing  the  following  changes:  convulsive  crises,  paralyses, 
contractures,  trembling,  choreic  movements,  disturbances  of 
speech,  of  respiration,  of  skin  sensibility  (anesthesia  and 


Meyer  Solomon 


339 


hyperesthesia),  of  the  special  senses  and  of  the  bladder. 

IDEAS  CANNOT  DIRECTLY  PRODUCE  PERIPHERAL  SENSORY 

CHANGES 

Although  Sidis4  does  not  take  up  for  discussion  the 
particular  subject  which  is  being  dissected  in  this  paper, 
still,  he  has  given  us  valuable  viewpoints  which  throw  much 
light  on  it  and  help  to  solve  it  for  us. 

Ideational  and  perceptual  processes  are  distinct  from 
one  another  and  by  no  manner  of  means  can  be  identified. 
Aside  from  other  differences,  the  percept  is  essentially 
sensory,  while  the  idea  is  not.  “Ideas  and  images  are  not 
possessed  of  magic  virtues,  and  with  all  the  fancy  work  about 
them,  they  cannot  display  sensory  qualities.”  A sensation 
cannot  possibly  be  called  up  at  will.  Although  there  is 
memory  for  images,  there  is  not  memory  for  sensations. 

In  his  discussion  of  what  he  properly  calls  primary  and 
secondary  elements  and  their  relationship  to  hallucinatory 
perception,  he  insists  that  hallucinations  are  always  peri- 
pherally induced,  and  would  define  or  explain  an  hallucina- 
tion as  a system  of  secondary  sensory  elements  dissociated 
from  their  primary  nuclear  elements. 

Furthermore,  in  his  consideration  of  hypnotic  hallu- 
cinations, so-called,  his  final  conclusion  is  “that  hypnotic 
and  post-hypnotic  suggested  hallucinations  are  not  genuine , 
but  are  essentially  spurges;  that  hypnotic  hallucinations , 
unlike  .actual  hallucinations , are  not  really  experienced;  that 
hypnotically  suggested  hallucinations  are  only  forms  of  de- 
lusions. ”5  (Italics  Sidis’.) 

His  belief  in  the  non-existence  of  real  hypnotic  and  post- 
hypnotic hallucinations  would  naturally  flow  out  of  his 
differentiations  between  ideational  and  perceptual  processes. 

Personally  I believe  that  Sidis  is  right. 

This  means  that  by  purely  ideational  influences,  without 
the  intermediate  reenforcement  by  other  states,  ideas,  per  se, 
cannot  induce  peripheral  sensory  processes.  Hence  hallu- 
cinations of  vision,  or  hearing,  or  smell,  or  feelings  of  cold, 
or  warmth,  or  the  like,  cannot  be  called  into  being  by  the 
power  of  ideas. 


340  How  Far  Can  Ideas  Influence  Peripheral  Processes 

In  a recenU  paper,  I showed,  at  least  to  my  own  satis- 
faction, that  true,  peripheral,  local  pains  cannot  be  caused 
by  ideational  processes.  This  would  be  the  natural  con- 
clusion of  the  views  just  expressed. 

IDEAS  CANNOT  DIRECTLY  AFFECT  THE  INVOLUNTARY  NERVOUS 

SYSTEM 

If  ideas  cannot  even  directly  affect  the  peripheral 
sensory  processes  in  the  voluntary  nervous  system,  how 
much  more  impossible  is  it  for  them  to  produce  changes  in 
the  action  of  the  involuntary  nervous  system  with  its  two 
great  subdivisions,  the  vagus  and  the  sympathetic  groups! 

From  self-observation  and  self-study,  I believe  we  can 
say,  with  full  truth,  that  pure  ideas,  whether  as  auto  or 
heterosuggestion,  cannot  have  any  direct  influence  on  those 
functions  which  are  directly  under  the  control  of  the  invol- 
untary nervous  system,  and  that  they  can  have  only  a 
temporary,  inhibiting  or  enhancing  effect  upon  those  functions 
which  are  not  entirely  under  the  dominance  of  the  involuntary 
nervous  system  but  over  which  the  self-consciousness  of 
the  individual  still  has  some  control.  In  the  latter  group  we 
have  such  functioning  as  bladder  and  rectal  control,  the 
movements  of  the  chest,  the  tendon  reflexes.  Under  the 
heading  of  the  involuntary  nervous  system  we  have  all  sorts 
of  visceral  and  peripheral  functions  of  a vital  nature.  Here 
we  must  not  fail  to  include  the  secretory,  vasomotor,  and 
trophic  phenomena.  The  functioning  of  the  cardiovascular- 
renal  system,  of  the  stomach  and  intestines,  and  the  like, 
plus  that  of  the  ductless  glands,  comes  in  for  the  same  la- 
belling. Emotionalism  may  directly  effect  these  involun- 
tary, vital  processes,  but  ideas  themselves  are  totally  in- 
capable of  directly  affecting  them.  Ideas  may  indirectly 
have  such  action  by  the  intermediate  incitement  of  the 
emotions,  especially  those  of  a depressing,  disintegrating 
nature. 

VOLUNTARY  INHIBITION 

Ideas,  when  they  have  us  in  their  grip,  can  have  an 


Meyer  Solomon  341 

inhibiting  effect  upon  the  self-consciousness  of  certain 
peripheral  processes. 

This  inhibiting  or  repressing  or  suppressing  effect  is  due 
to  the  change  produced  in  the  threshold  of  consciousness  at 
the  particular  moment  for  various  sorts  of  peripheral  irrita- 
tions. Here  comes  the  value  of  a stoical  attitude  in  life, 
of  self-control,  and  the  like. 

Nothing  that  has  been  said  up  to  this  point  should  in 
any  way  detract  from  the  value  and  import  of  hypnosis  and 
other  methods  of  mental  treatment  wherever  indicated. 

CONCLUSIONS 

Ideas  can  lead  to  functioning  of  the  voluntary  nervous 
system. 

Ideas  cannot  directly  affect  peripheral  processes  wholly 
under  the  domination  of  the  involuntary  nervous  system. 

Even  in  the  case  of  the  voluntary  nervous  system,  ideas 
cannot  produce,  in  direct  manner,  activity  of  a sensory 
nature.  Hence,  hallucinations  of  any  kind  cannot  be  due 
directly  to  ideas. 

Ideas  can  lead  to  functioning  in  the  voluntary  motor 
system. 

Ideas  can  indirectly  affect  the  involuntary  nervous 
system  by  exciting  the  emotions. 

By  ideas  we  may  inhibit  or  repress  from  self-conscious- 
ness the  awareness  of  certain  peripheral  processes. 

Ideas  cannot  directly  produce  or  call  into  being  pains 
of  a true  type. 

Note. — In  referring  to  what  one  may  with  a fair  measure  of 
justice  speak  of  as  so-called  pure  ideas  or  ideational  processes  I have 
in  mind  calm  thinking,  even  though  it  be  somewhat  reflective  and 
critical.  In  such  thinking,  although  to  a certain  extent  the  bodily 
organism  other  than  the  brain  is  taking  part  in  the  work,  com- 
paratively little  drain  on  the  energies  of  the  body  is  brought  about 
and  the  deeper  levels  of  reserve  energies,  and  the  phylogenetically 
older  protective  defenses  of  the  involuntary  nervous  system, 
ductless  glands  and  physico-chemical  processes  are  practically  not 
at  all  called  upon.  This  is  not  the  case  in  excited  thinking  or  very 
intensely  critical  thinking.  The  greater  the  degree  of  concen- 
tration and  intensity  in  thinking,  the  greater  the  associated  ex- 


342  How  Far  Can  Ideas  Influence  Peripheral  Processes 

citement  and  emotionalism,  so  much  the  greater  is  the  energy 
expenditure  and  the  more  the  involuntary  and  voluntary  nervous 
systems  take  part  in  the  work  at  hand. 

In  the  latter  case,  the  effort  is  more  pronounced,  the  drive  or 
attack  or  defense  or  adaptation  (call  it  what  you  will)  has  sum- 
moned into  action  more  and  more  hidden  and  remote  lines  of 
defense.  As  a consequence  the  results  are  fatiguing  and  the  activ- 
ity is  relatively  of  brief  duration  (is  this,  too,  biologically  protec- 
tive?), and  there  is  a tremendous  drain  on  lower  and  lower  levels 
of  activity  within  and  without  the  nervous  system.  In  such  in- 
stances even  the  most  distant  peripheral  processes  may  rush  to 
the  rescue,  so  to  speak,  and  take  part  in  the  encounter — in  the 
work  of  thinking — especially  if  the  state  of  bodily  health  and  the 
stability  is  considerably  below  par,  from  any  cause. 

Here,  however,  we  are  discussing  purely  physiological  or 
mechanistic  effects  or  concomitants  and  not  changes  produced  by 
the  direct  summoning  power  of  ideas  per  se. 

Furthermore  we  should  be  careful  not  to  credit  ordinary  con- 
centrated thinking  with  too  great  powers  of  producing  or  rather 
being  accompanied  by  peripheral  changes.  For  instance,  K.  S. 
Lashley  (The  Human  Salivary  Reflex  and  Its  Use  in  Psychology, 
Psychological  Review,  XXIII,  No.  6,  November,  1916)  quotes 
B.  Brunacci  and  T.  De  Sanctis  as  having  reported  “experiments 
to  show  that  intense  mental  application  (translation  from  a foreign 
language,  computation,  etc.)  partially  inhibits  secretion  of  the 
parotid”  but  he  concludes  that  he  cannot  find  that  these  authors 
have  controlled  a source  of  error  in  their  technique  which  he  points 
out. 

References 

1.  William  James:  The  Principles  of  Psychology,  Volume  2. 
p.  449. 

2.  To  appear  in  New  York  Medical  Journal. 

3.  J.  Babinski:  Demenbrement  de  l’hysterie  traditionelle. 
Pithiatisme.  La  Semaine  Medicale,  January  6,  1909,  No.  1,  p.  1. 

4.  Boris  Sidis:  The  Foundations  of  Normal  and  Abnormal 
Psychology.  Chapters  XXI  and  XXII. 

5.  Boris  Sidis:  Symptomatology,  Psychognosis  and  Diagno- 
sis of  Psychopathic  Diseases,  p.  243. 

6.  Are  There  Subjective  Pains?  To  appear  in  Medical 
Record  (N.  Y.). 


EUPATHICS— A PROGRAM  FOR  MENTAL  HYGIENE 

By  Abraham  Myerson,  M.  D. 

Clinical  Director  and  Pathologist , Taunton  State  Hospital , 
Taunton , Mass.,  Department  Neuropathology,  Harvard 
U niversity 

THE  professional  observers  of  their  fellowmen  have 
always  aligned  themselves  in  one  of  two  opposing 
groups.  The  first  group,  fiercely  insistent  upon 
focusing  its  glance  upon  the  possibilities  of  human 
culture,  has  fought  for  an  equalization  of  environmental 
conditions.  This  group  claims  the  bulk  of  the  radicals,  for 
since  these  view  the  successful  mainly  as  monopolists  of 
opportunity,  they  clamor  for  a change  in  order  to  equalize 
conditions.  The  other  group,  impressed  by  the  extra- 
ordinary advantages  of  being  well  born,  has  leaned  to  an 
aristocratic  view  of  life,  creating  kings,  noble  families,  and 
the  whole  paraphernalia  of  congenitally  dominant  classes. 
Here,  belong  the  conservatives  who  see  in  the  established 
order  of  things,  the  supremacy  of  the  best  and,  therefore, 
sternly  resist  change. 

In  a very  large  measure  these  two  view  points  divide  up 
Psychiatry  and  Neurology.  Corresponding  to  the  en- 
vironmentalists is  a group  that  lays  emphasis,  as  causes  of 
the  psychoses  and  neuroses,  upon  bad  training,  poverty, 
sickness,  and  especially  following  Freud,  upon  vicious  circles 
in  the  emotional  and  intellectual  life  arising  through 
conflicts  between  personal  desire  and  the  social-ethical 
organization.  The  other  group,  larger  in  number,  con- 
trolling as  yet  the  institutions  and  the  colleges,  places  the 
blame  upon  inheritance  and  seeks  to  mend  matters  by  sub- 
stituting a responsible  system  of  mating  for  the  present 
irresponsible  giving  and  taking  in  marriage.  Society,  these 
workers  say,  must  step  in,  forbid  the  marriage  of  the  unfit, 
sterlize  them,  if  necessary,  and  thus  prevent  the  growth  of 


343 


344  Eupathics- — A Program  for  Mental  Hygiene 

human  weeds.  From  these  ideas  was  born  the  goddess  of 
right  mating,  Eugenia,  who  severely  frowns  on  Venus,  and 
whose  followers  call  themselves  Eugenists. 

Now  T have  no  quarrel  with  Eugenics  and  indeed  am 
greatly  interesied  that  its  work  of  introducing  genuine  good 
breeding  into  society  shall  go  on,  but  I quarrel  with  the 
Eugenists  who  make  it  the  whole  of  a program  of  Mental 
Hygiene.  My  objections  arise  on  two  grounds:  the  one, 
logical ; the  second  and  more  important,  practical.  Logically 
because  the  part  is  not  equal  to  the  whole.  Practically, 
because  the  field  of  Mental  Hygiene  which  I desire  to  em- 
phasize has  for  its  aim  the  well  being  of  the  normal , while 
Eugenics  largely  simmers  down  to  a program  for  the  elimina- 
tion of  the  unfit.  Eugenics  points  out  in  charts  and  figures 
the  cost  of  maintaining  Insane  Hospitals,  Feeble-Minded 
Schools  and  Jails.  Eupathics 1,  its  more  gracious  sister 
speaks  of  means  by  which  the  mood  of  Mankind  may  be 
elevated.  Essentially,  it  is  a democratic  program  seeking 
to  irradiate  throughout  Society  the  tone  and  mood  that  now 
graces  the  lives  of  very  few. 

One  must  at  this  point  meet  the  objection  of  those  who 
are  quick  to  take  alarm  at  any  program  that  savors  of  senti- 
mentality. No  alarm  need  be  felt  on  this  score  for  Eupathics 
is  a scientific  conception  based  on  the  fact  that  Mood,  the 
dynamo  of  the  psyche,  can  be  reached  and  elevated  in  a per- 
fectly definite  manner.  This  entails  at  least  a short  analysis 
of  the  present  day  conception  of  Mood  or  feeling,  for  Eu- 
pathics holds  that  the  problem  of  Mental  Hygiene  should  be 
very  largely  a problem  of  Mood  Hygiene. 

Mood  is  a real  source  of  the  energy  and  happiness  of  the 
individual.  Mind  faces  the  world,  adjusts  Man  to  it,  but 
Mood  gives  to  Mind  the  strength  and  the  desire  to  go  on 
living  or  else  brings  about  apathy  and  the  wish  to  die.  Mood 
arises  from  two  sources.  The  first  is  the  resultant  of  the 
combined  functioning  of  the  organs.  Today  we  can  corre- 
late Mood,  in  part  at  least,  with  the  secretion  of  adrenalin, 
the  reaction  of  the  enzymes,  the  oxygenation  of  the  tissues, 

rI  owe  the  coinage  of  this  word  to  my  friend,  Professor  Charles  St.  Clair  Wade. 
I think  it  conveys  what  I mean  better  than  any  word  that  is  used.  Eudaemonism 
means  too  nearly  happiness  to  give  the  idea  of  mood  in  general. 


Abraham  Myers  on 


345 


the  tone  of  the  arteries.  But  always  Man  has  known  that 
the  glasses  through  which  he  viewed  the  world  were  colored 
by  the  state  of  his  digestion,  and  spoke  of  melancholia  as 
arising  literally  from  retained  bile,  spoke  of  anger  as  splenic, 
etc.  One  is  here  reminded  of  the  famous  story  that  concerns 
the  suicide  pact  made  by  Voltaire  and  the  Englishman  who 
had  agreed  with  the  sage  that  Life  was  not  worth  living. 
On  the  morning  of  the  day  appointed  for  the  exit  from  Life, 
the  Englishman,  arriving  at  Voltaire’s  house,  found  that 
worthy  busily  engaged  in  doing  away  with  a good  meal,  at 
the  same  time  enjoying  a risque  story.  The  Englishman 
expostulated  and  reminded  the  philosopher  of  his  agreement. 
But  the  latter  waved  him  aside.  “ Aujourdhui,  ” “dit  il” 
“ J’ai  bien  opere.  ” 

The  difference  between  the  old  and  the  young  is  largely 
one  of  mood,  and  could  we  join  the  sad  experiences  of  the 
aged  to  the  vigorous  tissues  of  youth,  we  would  still  find  the 
gay  exuberance  that  no  intellectual  perception  of  the  futility 
of  life  can  check.  Behind  the  interest  we  can  summon  for 
our  tasks,  the  zeal  and  sureness  of  our  actions,  the  con- 
sciousness of  power  and  courage  is  a silent  reservoir,  a 
pressure  of  energy  whose  dimly  conscious  manifestation  is 
the  mood  created  by  the  unconscious  organs.  We  have 
then  in  the  general  health  conservation,  in  all  programs  that 
look  to  a better  physical  Mankind,  a true  Mental  Hygiene 
program,  one  that  gives  a rationale  for  Health  as  a founda- 
tion for  the  Happiness  of  Man. 

The  dependence  of  mood  upon  health  and  energetic 
organs  is  most  easily  studied  in  the  very  young  child.  Here 
are  no  definite  purposes  to  steady  the  conduct,  or  to  obscure 
the  change  in  mood,  as  is  the  case  in  adults.  Fatigue  changes 
the  sweetest  natured  child  of  two  or  three  into  a restless, 
querulous,  unsociable,  uninterested,  little  creature,  whose 
main  characteristic  becomes  a decided  negativism.  And 
sickness  plays  upon  the  mood  of  a child  as  an  organist 
plays  on  his  instrument,  so  that  every  change  is  reflected 
in  the  child’s  conduct.  Changes  in  the  mood  of  children 
are  really  temporary  psychoses  and  constitute  a much 
neglected  field  for  the  study  of  the  genesis  of  mental  diseases. 

But  this  is  not  all.  Other  things  than  the  personal 


346  Eupathics — A Program  for  Mental  Hygiene 

bodily  health  create  mood.  The  social  health  breeds  a social 
mood  that  varies  with  the  state  of  its  cause.  That  these 
moods  are  racial  in  a biological  sense  is  probably  true  only 
in  very  limited  measure  for  the  various  ethnic  strains  in  any 
large  community  usually  have  moods  corresponding  to  their 
social  position  rather  than  to  their  racial  origin.  Nothing 
is  so  contagious  as  mood, — the  preventible  misery  of  the 
world  acts  as  a tragic  destroyer  of  buoyant  mood  even  for 
those  who  are  not  actually  touched  thereby.  The  story  of 
Buddha  and  his  reaction  to  the  poverty,  old  age,  sickness  and 
death  around  him  is  the  story  of  us  all,  even  though  we 
react  without  definite  consciousness  of  cause,  by  a cynicism 
and  a hardness  that  is,  after  all,  an  armor  for  our  too  delicate 
souls.  Though  we  had  not  an  enormous  machinery  for 
diffusing  social  moods,  in  the  newspaper,  book,  moving 
picture  and  theatre,  personal  contact  alone  bringing  to  us 
the  misery  of  our  fellows  brings  a toned  down  despair, 
an  ever  simmering  discontent.  The  “insolence  of  acci- 
dents,” the  bitterness  of  injustice,  every  case  of  merit  dis- 
regarded and  of  vice  rewarded  adds  to  a mood  which  takes 
zest  from  living,  energy  from  action  and  graciousness  from 
conduct.  A society  in  which  most  men  and  women  live 
continuously  on  the  brink  of  disaster  is  a society  whose 
mood  is  poisoned  by  an  insidious  auto-intoxication.  And  to 
preach  “Don’t  worry  ” to  the  clear-sighted  person  continually 
foreseeing  really  imminent  economic  and  social  ruin  is  as 
futile  as  it  is  unsympathetic. 

Eupathics  looms  suddenly  very  large.  A program  for 
promoting  the  health  of  the  individual  and  the  health  of 
society  in  order  that  a better  basic  mood  may  arise — -what 
then  is  left  out?  The  answer  is,  nothing  of  consequence. 
For  essentially  a better  basic  mood  is  the  condition  of 
happiness  and  efficiency,  these  given  their  largest  applica- 
tion. And  he  who  steps  in  to  conquer  a disease,  or  who 
solves  municipal  housing  problems,  or  prevents  by  a device 
the  avoidable  accident,  or  releases  man  from  boredom  or 
fatiguing  drudgery,  or  who  creates  new  beauty — all  such 
are  workers  in  Mental  Hygiene,  workers  in  the  field  of 
Eupathics.  Who  can  measure  the  uplift  in  the  mood  of 
Man  by  the  conquering  of  hookworm  disease,  and  who  can 


Abraham  Myers  on 


347 


measure  the  value  of  the  vacuum  cleaner  to  the  housewife? 
And  if  a Charlie  Chaplin  brings  the  comfort  and  blessing  of 
solid  laughter  to  those  not  easily  reached  otherwise,  then  we 
must  class  him  as  a benefactor,  a force  working  in  Mental 
Hygiene,  whatever  we  may  think  of  his  art. 


REVIEWS 


STUDY  OF  ORGAN  INFERIORITY  AND  ITS  PSYCHICAL  COMPENSA- 
TION. A Contribution  to  Clinical  Medicine.  By  Dr.  Alfred  Adler , 
of  Vienna.  Authorized  translation  by  Smith  Ely  Jelliffe , M.  D. 
New  York:  The  Nervous  and  Mental  Disease  Publishing  Com- 
pany, 1917,  $1.50,  pp.  86. 

This  is  No.  24  of  the  Nervous  and  Mental  Disease  Monograph 
Series. 

It  is  the  foundation,  upon  which,  with  additions,  Adler  de- 
veloped his  theory  of  the  so-called  neurotic  constitution,  as  given 
in  his  book  recently  translated  into  English  under  the  name  of 
The  Neurotic  Constitution,  and  which  was  reviewed  by  me  in  the 
Journal  of  Abnormal  Psychology  for  August,  1917. 

For  the  benefit  of  the  reader  I shall  review,  in  running  fashion, 
so  to  speak,  going  from  chapter  to  chapter,  this  monograph  by 
Adler. 

Adler  considers  the  causes  of  the  localization  of  disease.  His 
fundamental  thesis  is  that  the  cause  of  localization  of  disease  is 
to  be  found  in  the  primary,  fundamental,  relative  somatic  or 
physiological  inferiority  of  the  organ  or  system  affected. 

The  proofs  of  organ  inferiority  are  to  be  found,  if  we  follow 
Adler,  in  (1)  heredity,  (2)  anamnestic  demonstration,  (3)  morpho- 
logic characteristics,  (4)  reflex  anomalies,  (5)  manifold  or  multiple 
organ  inferiorities,  and  (6)  in  the  reactions  on  the  part  of  the  ner- 
vous system  as  seen  in  the  development  of  neuroses  and  psychoses. 

In  his  chapter  on  “Heredity”  he  does  not  differentiate  be- 
tween congenitality  and  heredity  (true  germinal  inheritance).  He 
refers  especially  to  familial  inheritance  and  apparently  fails  to 
realize  that  he  is  dealing  with  the  problem  of  the  hereditary  trans- 
mision  of  acquired  traits,  in  this  special  instance,  of  organ  in- 
feriorities of  specific  types,  and  in  this  respect  his  arguments  and 
reasoning  are  superficial ; not  at  all  as  careful  as  that  of  the  biome- 
tricians and  Mendelians  who  have  been  thinking  along  the  same 
line.  He  differentiates  between  the  heredity  of  disease  and  the 
heredity  of  organ  inferiority  and  declares:  “The  inferiority  of  an 
organ  may  reveal  itself  in  the  descendants  in  the  most  diverse 
parts  of  the  organ” — and  by  “organ”  he  generally  means  system 
(gastro-intestinal,  respiratory,  and  the  rest).  Acquired  causes 
of  disease  are  considered  as  secondary,  incidental  factors. 

Adler  loses  sight  of  the  fact  that  the  total  number  of  physio- 
logical systems  is  but  a handful  (count  them  if  you  doubt  it),  and 
hence  it  is  no  wonder  that  different  members  of  the  same  family 


348 


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349 


may  show  some  disorder  at  some  time  or  other  in  their  lives  in  the 
same  organs  or  systems. 

His  chapter  on  “Anamnestic  demonstration”  demonstrates 
nothing  in  particular  in  proof  of  his  main  contentions.  He  refers 
to  such  early  signs  of  organ  inferiority  as  bed-wetting  and  the  like. 

Under  “Morphologic  Indications  of  Organ  Inferiority”  he 
refers  to  external  signs  of  so-called  degeneration,  the  so-called 
stigmata,  which  may  be  present  or  absent,  and  to  hidden,  internal 
inferiorities  which  show  themselves  by  disturbance  of  function 
and  of  the  related  reflexes.  He  also  mentions  segmental  inferiority 
as  the  cause  of  segmental  disease.  He  omits  all  sorts  of  acquired 
causes  responsible  for  these  changes. 

In  his  discussion  of  “Reflex  Anomalies  as  Indications  of  In- 
feriority,” increase  or  decrease  in  reflex  reactions  of  all  sorts  is 
considered  as  abnormal  and  a sign  of  inferiority.  Adler  would  have 
to  define  here  just  what  he  means  by  “inferiority,”  “normal,” 
“increase”  and  “decrease.”  What  is  his  standard?  Is  not  most 
of  this  mere  guesswork,  except  in  extreme,  positive,  clear-cut 
cases?  He  even  goes  to  the  extreme  of  coming  out 
for  familial,  hereditary  transmission  of  reflex  reaction  types  of 
varying  degrees,  in  all  parts  of  the  body,  as,  for  example,  increased 
or  decreased  palatal  reflex.  Who  knows  what  a normal  palatal  re- 
flex is?  Who  is  to  be  judge  of  this  in  borderline  cases? 

Under  “Manifold  Organ  Inferiorities,”  he  refers  to  multiple 
organ  inferiorities,  and  again  comes  out  for  the  hereditary  trans- 
mission down  the  family  tree  of  organ  inferiorities  of  different 
systems,  these  system  inferiorities  being  transmitted  like  Mendelian 
units,  it  would  appear.  Even  complications  in  disease  are  always 
determined  by  organ  inferiorities  of  a familial  type.  He  does  not 
consider  use  or  abuse,  wear  and  tear,  fatigue  or  not  of  the  indi- 
vidual organs  and  systems  occurring  as  the  result  of  the  life  condi- 
tions of  the  individual. 

In  this  chapter  he  makes  the  peculiar  statement,  which 
he  repeats  in  The  Neurotic  Constitution,  that  “every  organ 
inferiority  carries  its  heredity  through,  and  makes  itself  felt  by 
reason  of  an  accompanying  inferiority  in  the  sexual  apparatus.” 

In  the  next  chapter  on  “The  Part  Played  by  the  Central 
Nervous  System  in  the  Theory  of  Organ  Inferiority.  Psycho- 
genesis and  Foundations  of  Neuroses  and  Psychoses,”  he  presents 
views  which  have  been  developed  at  great  length  in  The  Neurotic 
Constitution.  His  discussion  of  physiological  activity  in  this 
chapter,  as  well  as  most  of  his  reasoning  throughout  The  Neurotic 
Constitution,  is  a somewhat  anthropo-morphic,  ideocentric  view- 
point. 

In  the  succeeding  chapter  on  “Biologic  Viewpoint  in  Organ 
Inferiority  Theory,”  I find  that  Adler  reverses  his  position  and 
now  properly  speaks  not  of  true,  germinal  inherited  inferiority 
but  of  embryonic,  congenital,  and  hence  acquired  inferiority — 


35° 


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acquired  in  the  course  of  development  of  the  cells  and  organs  as  a 
direct  result  of  their  life  conditions.  He  correctly  enumerates  as 
the  causes  of  organ  inferiority  only  acquired  conditions  affecting 
the  spermatozoon  or  ovum  or  developing  embryo.  If  I were  so 
inclined  I could  here  show  that  this  chapter  could  be  used  to  ex- 
plode most  of  the  views  expressed  earlier  in  the  work.  Here,  too, 
there  is  a hint  of  Roux’  theory  of  the  struggle  for  survival  between 
the  individual  cells  and  organs. 

Finally,  in  an  appendix,  Adler  applies  his  views  to  the  urinary 
apparatus  in  particular. 

Throughout  the  volume  Adler  has  assumed  a careless,  dog- 
matic attitude,  his  statements  are  too  often  far-fetched, 
unscientific  and  unfounded.  The  numerous  cases  he  introduces 
as  evidence  in  support  of  his  claims  do  not  prove  a thing. 

Now,  what  is  the  conclusion  one  should  draw  from  all  that 
Adlersays  of  organ  inferiority  ? English,  French  and  American  neur- 
ologists have  pointed  this  out  long  since,  and  all  workers  in  the  field  of 
psychopathology  will  doubtless  agree  to  the  following  statement: 
There  is  such  a thing  as  a sensitive,  Irritable,  impressionable  con- 
stitution. This  may  be  localized  or  of  a more  general  nature.  If 
it  affects  the  nervous  system  only,  we  may  call  it  neuropathy. 
Organopathy  may  be  used  as  a general  term.  We  have  for  a long 
time  been  using  the  terms  “constitutional,”  “constitutional 
makeup,”  “constitutional  inferiority,”  irritable  weakness,  in- 
stability, neuropathic,  defectively  and  unstably  organized,  and 
the  like.  This  instability  is  congenital  or  acquired  during  the  life- 
time of  the  individual  from  one  cause  or  another.  The  causes  of 
congenital  instability  are  prenatal,  in  the  mother  or  father,  thus 
affecting  the  germ  cells  before  union,  or  in  the  mother  alone,  after 
union  of  the  germ  cells.  The  causes  are  various — syphilis,  tuber- 
culosis, lead  poisoning,  inanition,  local  inflammatory  diseases  of 
the  reproductive  organs,  etc. 

We  know,  too,  that  several  members  of  the  same  family  may 
be  affected  with  system  inferiority,  especially  of  the  nervous  sys- 
tem. For  instance,  syphilis  in  one  or  both  of  the  parents  may  be 
responsible  for  a neuropathic  condition  in  several  or  even  all  of  their 
offspring. 

The  question  of  the  possibility  of  acquired  instability  of  a 
general  nature  which  can  be  transmitted  by  heredity  for  at  least 
a few  successive  generations  has  not  been  positively  settled  in 
human  beings  up  to  date,  so  far  as  I see,  in  spite  of  much  splendid 
work  that  has  been  done  along  this  line.  This  seems  to  be  true 
for  certain  mammals,  as  proven  by  the  experiments  of  Stockard 
and  his  associates  in  their  studies  of  the  hereditary  transmission 
of  degeneracy  and  deformities  by  the  descendants  of  alcoholized 
mammals  (American  Naturalist,  Parts  I and  II,  \ ol.  L,  February 
and  March,  1916,  p.  65.  See  also  Stockard’s  article  in  Interstate 
Medical  Journal,  June,  1916,  Vol.  XXIII,  No.  6,  and  the  references 


Reviews 


351 


there  quoted.) 

The  question  of  the  hereditary  transmission  of  acquired  in- 
stability of  specific  types  (organs  or  systems)  leads  one  to  a con- 
sideration of  the  general  problem  of  the  possibilities  and  degrees 
of  the  germinal  inheritance  of  acquired  physiological  traits. 

There  are  all  degrees  of  instability  or  irritability  of  this  or 
that  organ. 

Instabilities  of  varying  kinds  and  degrees  may  occur  in  high- 
ly or  lowly  organized  systems. 

Although  Adler  has  tried  to  catch  too  many  fish  in  the  same 
net,  and  although  his  efforts  to  prove  the  hereditary  transmission 
of  specific  types  of  system  instability  are  not  successful,  yet  this 
little  monograph  goes  far  to  prove  that  there  are  all  sorts  of  con- 
stitutional physiological  inferiority  or  instability  or  irritability, 
and  if  there  be  any  who  doubt  this,  Adler’s  discussion  will  con- 
vince him  of  at  least  that  much. 

Rosenow’s  work  and  his  belief  in  the  existence  of  the  selective 
affinity  of  certain  organisms  for  certain  special  tissues  as  the  cause 
of  all  sorts  of  diseased  conditions,  such  as  arthritides,  nephritides 
and  the  like,  are  interesting  when  contrasted  with  the  views  of 
Adler  as  expressed  in  the  volume  under  review. 

The  fundamental  problem  with  both  of  them  is  the  causation 
of  the  localization  of  disease  or  the  locus  minoris  resistentiae. 

Adler’s  views  are  interesting,  furthermore,  if  we  use  the  theory 
of  organ  or  partial  organ  inferiority  or  instability  to  account  for 
so  many  of  the  peculiar  conditions  we  find  in  dementia  precox, 
feeblemindedness  and  similar  conditions.  Yet  many  others  for 
some  time  past  have  been  speaking  of  ageneses  and  aplasias,  hypo- 
plasias and  the  rest. 

As  in  his  other  writings,  Adler  writes  with  much  force,  and 
although  his  arguments  are  too  oft  not  convincing,  they  are  surely 
suggestive. 

The  translator  accomplished  his  difficult  task  satisfactorily, 
although  his  job  was  not  an  easy  one. 

Meyer  Solomon. 

THE  HISTORY  AND  PRACTICE  OF  PSYCHANALYSIS.  By  Poiil 
Bjerre , M.  ZX,  translated  by  Elizabeth  N.  Barrow.  Boston:  Richard 
G.  Badger,  1916,  $3.00  net,  Pp  294. 

The  various  chapters  in  this  work  deal  with  “Kant  and 
Feuchtersleben, ” “ Wetterstrand  and  the  Nancy  School,”  “Psych- 
analysis  as  a Science  and  Method  of  Treatment,”  “The  Adler- 
Doctrine  Concerning  Neurosis,”  “The  Nature  of  Hypnosis,” 
“The  Conscious  Versus  the  Unconscious,”  “Extract  from  a Case- 
history,”  and  finally  “Points  of  View  and  Outlook.” 

It  is  surprising  to  find  that  this  author,  who  seems  to  be 
versed  in  the  main  steps  in  the  historical  evolution  of  our  knowl- 
edge in  more  recent  times  of  psychopathic  states,  has  neglected  the 


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very  important  and  fundamental  work  of  Janet,  Prince  and  Sidis. 
Surely  Janet,  whose  name  should  at  once  come  to  mind  with  the 
mere  mention  of  such  other  students  in  France  as  Charcot.  Bern- 
heim,  Dejerine,  Dubois,  and  others  (whom  Bjerre  refers  to)  might 
have  come  in  at  least  for  a passing  recognition. 

The  author  adopts  a really  impartial  and  fairminded  attitude 
with  respect  to  the  Freud-Adler  controversy,  and  agrees  with  those 
w'ho  see  Freud  in  error  in  his  exclusively  sexual  viewpoint. 

It  is  to  be  noted  that  Bjerre  here  includes  Adler’s  views  under 
“psychoanalysis,”  with  which  the  book  deals.  I have  elsewhere 
expressed  the  view  that  the  term  “psychoanalysis”  be  limited  to 
mental  analysis  in  accordance  with  the  theories  and  methods  of 
Freud.  Others  have  advocated  its  employment  in  a similar  sense. 
And  Freud  himself  refuses  to  admit  that  either  Jung  or  Adler 
practises  what  he  is  pleased  to  call  “psychoanalysis,”  and  has 
read  both  of  them  out  of  the  psychoanalytic  movement.  If  we 
view  things  in  this  light,  then,  Adler  is  not  a psychoanalyst, 
although  he  has  erred  in  adopting  some  of  the  erroneous  viewpoints 
of  the  Freudian  school  in  spite  of  his  having  modified  the  system 
in  certain  other  fundamental  and  worthy  directions. 

Bjerre,  too,  although  assuming  a very  commendable  and 
broadminded  attitude,  and  although  he  does  not  seem  to  belong 
to  any  of  the  schools  and  is  apparently  seeking  the  truth  no  matter 
whence  it  comes,  has  permitted  himself  to  fall  into  certain  pitfalls. 
He  has  failed  to  adopt  a truly  biological  and  evolutionary  view- 
point. He  has  clung  to  a too  exclusively  individualistic  and 
purely  psychological  (really  ideational)  conception,  and  has  con- 
tinued to  worship  at  the  shrine  of  philosophy  and  interpretation, 
applying  these  viewpoints  to  the  understanding  of  psychopathic 
states.  There  is,  as  a result,  a noticeable  tendency  to  say  it  is 
“proven”  when  he  means  it  “seems  as  if,”  and  the  like. 

He  believes  hypnosis  to  be  the  temporary  sinking  back  into 
that  primary  state  of  rest  which  obtained  during  fetal  life.  This 
is  also  an  “as  if”  interpretation.  The  turning  on  of  the  light  to 
be  derived  from  a broad  biological  and  evolutionary  viewpoint 
clears  this  subject  up  at  once. 

“Extract  from  a Case-history”  is  a very  interesting  presenta- 
tion of  the  treatment  and  cure  of  a paranoidal  state.  Those  who 
aspire  to  treat  these  conditions  or  are  making  serious  efforts  in  this 
direction  would  profit  greatly  by  a reading  of  this  chapter. 

Although  the  author  does  not  contribute  any  particular  system 
of  his  own,  it  would  be  well  for  all  interested  in  this  subject  to  read 
this  work,  listen  well  to  the  candid  but  friendly  criticisms  offered, 
but  do  not  fail  to  take  note  of  the  errors  in  viewpoint  of  Bjerre 
himself. 

It  is  a sign  of  progress  when  free  spirits  come  forth  to  discuss 
frankly,  openly  and  impartially  the  pros  and  cons  of  a subject 
about  which  such  wordy  wars  have  been  waged  up  to  date,  and 


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353 


about  which  probably  much  more  will  be  said  in  the  future. 

All  hail  to  an  author  who  refuses  to  be  bound  down  by  any 
particular  system — whether  religious  or  otherwise — and  who 
strikes  boldly  from  the  common  path  of  tradition  to  hew  out  his 
own  course  to  what  he  believes  to  be  the  truth  or  near-truth! 

Meyer  Solomon. 

notes  on  affective  physiology.  By  George  Fan  Ness 
Dearborn.  Medical  Record,  April  8,  1916. 

Dearborn  has  written  many  papers  on  topics  allied  to  that 
discussed  in  the  present  paper.  Perhaps  the  paper  under  con- 
sideration gives  his  views  more  definitely  and  clearly  than  most 
of  the  other  papers  he  has  written  on  these  subjects. 

Psychology,  he  says,  now  needs  specific  information  about 
the  innervation  of  behavior — the  innervations  of  feeling  and 
emotion,  the  fundamental  principles  of  emotional  neurility,  neuro- 
kinesis, nervous  strains,  nerve  impulses,  as  he  variously  terms  it. 

He  lays  stress  on  the  importance  of  cenesthesia  and  of  partial 
cenesthesias  (from  the  individual  organs). 

His  fundamental  thesis  is  this:  “ . . . the  physical  or 

energy-aspect  of  feeling  is  numerous  sets  of  kinesthetic  neurokine- 
tic  strains  or  impulses  relating  all  layers  of  the  great  cortex  to  its 
affective  environment  (whether  the  latter  be  outside  the  body  or 
within  it),  the  conscious  inhibitory  phase  of  the  kinesthesia  repre- 
senting originally  the  feelings  unpleasant  in  tone,  and  its  sub- 
conscious actuating  phase  the  pleasant  emotion.” 

The  term  “kinesthesia”  is  here  used  to  include  practically  all 
information  or  impulses  that  enter  the -nervous  system  to  pass  up 
to  higher  and  higher  levels. 

The  integrations  at  the  higher  levels  of  the  nervous  system 
represent  symbolically,  so  to  say,  those  at  a lower  level. 

He  discusses  at  length  the  problems  of  actuation  or  the  impulse 
to  activity,  of  inhibition  and  of  integration  in  the  nervous  system, 
and  pays  particular  attention  to  neuromuscular  impulses  or  stimuli. 

We  may,  with  justice,  quote  some  of  his  summary,  as  repre- 
senting his  views  in  support  of  the  thesis  which  he  has  laid  down: 

“The  actuation  of  movement,  bodily  and  therefore  mental, 
in  the  normal,  unfatigued,  and  naive  individual,  is  the  primal  and 
enduring  delight  of  all  his  experience. 

“In  such  a personality  the  inherent  impulse  to  movement  in 
space  and  in  time  seems  to  be  represented  neurally  by  the  actuat- 
ing phase  of  kinesthesia  pleasant  in  tone  whenever  it  rises  out  of 
‘the  subconscious.’ 

“In  such  a personality,  too,  the  human  restraint  of  impulsive 
movement  in  emotion  seems  to  be  represented  by  the  unpleasantly 
conscious  inhibitory  phase  of  kinesthesia. 

“Organic  evolution  at  heart  is  an  ever-complexifying  process 
of  control  over  impulse. 


354 


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“In  the  triple  intricacies  of  the  great  cortex  is  the  only  ade- 
quate integrating  mechanism  for  that  particular  physiologic  balance 
(here  between  pleasant  actuation  and  unpleasant  inhibition) 
which  is  concomitant  on  the  usual  symbolic  plan  to  feeling. 

“As  the  child  develops  its  personality  properly  human,  a 
double  kind  of  submergence  seems  to  occur:  figuratively,  a sub- 
mergence of  unpleasantness  in  some  cases  into  an  habituated  sub- 
consciousness,  and  literally,  perhaps,  a submergence  of  neuronal 
motor  control  from  the  ‘neopallium’  into  the  deeper  layers  of  the 
cortex,  the  ‘archipallium.’  This  universal  process  in  no  way 
invalidates  the  kinesthetic  theory  of  feeling,  since  it  leaves  un- 
disturbed the  original  primary  influences  on  the  autonomic  and 
spinal  greys  as  well  as  the  secondary  resultants  therefrom  into  the 
cortex  by  way  of  the  distributing  thalamus.” 

Dearborn  has  made  a physiological  attack  upon  a tremendous- 
ly important  fortress.  In  fact  he  is  dealing  with  the  same  question 
which  is  holding  the  rapt  attention  of  so  many  workers  in  the 
field  of  psychopathology,  although  different  writers  and  thinkers 
are  using  different  terms. 

The  concepts  behind  such  terms  as  “sexual,”  “libido,”  “will 
to  power,”  “wish,”  “elan  vital,”  and  the  like  are,  to  a certain 
extent,  in  line  with  Dearborn’s  “actuation.” 

It  will  thus  be  seen  that  Dearborn’s  paper  will  be  read  with 
much  interest  by  all  psychopathologists. 

Dearborn’s  views,  however,  have  not  yet  come  to  a sharp-cut 
point.  He  is  still  battling  bravely  with  the  problem  he  has  under- 
taken to  explain  and  solve.  For  this  reason  we  may  expect  more 
work  from  him  in  this  direction,  and,  as  he  gets  a better  and  deeper 
grasp  upon  his  subconscious,  he  will  be  in  a position  to  strike  home 
with  more  powerful  hammer-blows,  in  his  attempts  to  drive  his 
views  into  our  thick  skulls. 

_ Meyer  Solomon. 

studies  in  forensic  psychiatry.  By  Bernard  Glueck , M.  D ' 
Boston:  Little,  Brown  & Co.,  1917,  $2.50  net,  pp.  269. 

This  is  number  2 of  the  recently  projected  series  of  mono- 
graph supplements  to  the  Journal  of  the  American  Institute  of 
Criminal  Law  and  Criminology. 

The  work  is  a collection  of  studies  previously  published  by 
Glueck  as  papers  in  different  journals.  The  five  chapters  of  the 
book  deal  with  “Psychogenesis  in  the  Psychoses  of  Prisoneis. ” 
“The  Nature  and  Treatment  of  the  Psychoses  of  Prisoners/’ 
“The  Forensic  Phase  of  Litigious  Paranoia,”  “The  Malingerer: 
A Clinical  Study,”  and  “The  Analysis  of  a Case  of  Kleptomania.  \ 

In  the  chapter  dealing  with  the  first  topic  mentioned  Glueck 
gives  a review  of  the  literature  on  the  subject  with  some  illustra- 
tive cases  coming  under  his  observation,  and  with  a discussion  of 
psychogenesis  in  the  psychoses  of  prisoners,  including  the  mental 


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355 


disturbances  of  so-called  degenerative  individuals,  which  latter 
group  of  mental  disorders  he  believes  to  be  essentially  psychogene- 
tic  in  origin. 

In  his  discussion  in  the  second  chapter  he  takes  up  the  general 
problem  of  the  nature  and  treatment  of  the  psychoses  of  prisoners, 
gives  illustrative  cases,  and  offers  some  i ecommendations  of  a 
practical  nature,  emphasizing  the  need  of  psychiatric  annexes  in 
connection  with  penitentiaries.  He  points  out  the  need  for  the 
study  of  adult  criminals,  of  the  recidivist  type,  from  the  psycho- 
pathologist’s viewpoint. 

Chapter  three  presents  two  interesting  case-histories  illus- 
trating the  importance  of  litigious  paranoia,  with  a brief  considera- 
tion of  some  of  the  problems  staring  one  in  the  face  in  this  field. 

Chapter  four  is  given  up  to  an  excellent  study,  from  our 
present-day  viewpoint,  of  the  malingerer.  I presented  an  ab- 
stract of  this  paper  in  the  Journal  of  Abnormal  Psychology 
for  August-September,  1916.  This  is,  as  I see  it,  the  best  chapter 
in  the  book. 

In  the  fifth  chapter  Glueck  offers  us  an  analysis  of  a case 
of  kleptomania  from  a more  or  less  psychoanalytic  point  of  view, 
in  which  he  believes  the  genesis  or  diiving  force  to  be  due  to  efforts 
to  sublimate  (in  this  particular  case  by  antisocial  conduct)  a trend 
toward  homosexuality  (anal-eroticism).  The  proof  for  this  con- 
clusion, is,  however,  not  convincing,  although  suggestive. 

It  is  seen,  therefore,  that  Glueck  has  here  attacked  the  pro- 
blem of  the  adult  recidivist  from  the  standpoint  of  the  modern 
psychiatrist  and  psychopathologist.  He  has  dealt  with  concrete 
problems  in  a cleancut,  practical  sort  of  way.  This  is  indeed  prog- 
ress from  the  tendencies  of  too  many  workers  in  this  field. 

Glueck  definitely  demonstrates  the  broadening  fields  of 
psychopathology.  It  is  the  psychopathologist,  with  his  medical, 
neurological,  psychological  and  psychopathological  training,  plus 
his  grasp  of  modern  social,  industrial,  economic  and  allied  con- 
ditions, who  will  do  most  to  solve  the  problem  of  the  adult  recidivist, 
the  drug  addict,  and  the  rest.. 

Healy,  by  his  pioneering  work  with  the  juvenile  delinquent, 
has  led  the  way. 

The  field  is  big,  the  ramifications  are  many,  and  the  solution 
of  the  problems  is  not  so  difficult  as  we  have  so  long  believed. 

The  papers  collected  in  this  book  are  the  result  of  Glueck’ s work 
in  the  criminal  insane  department  of  the  Government  Hospital  for 
the  Insane.  Since  these  papers  were  written  Glueck  has  become 
the  Director  of  the  Psychiatric  Clinic  at  Sing  Sing  Prison.  Here 
he  is  in  a far  better  position  to  deal  directly  with  the  great  problem 
of  the  adult  habitual  offender.  Now  that  he  is  closely  at  grips  with 
the  issues  to  be  met,  we  may  expect  valuable  contributions  which 
should  do  much  to  help  society  understand  the  causative  factors 
and  the  therapeutic  attack  on  the  problem. 


356 


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It  is  work  of  the  type  represented  in  this  book  which  will  do 
much  in  this  direction.  Intensive  study  of  individual  cases,  as  so 
well  carried  on  by  Healy  with  the  juvenile  offender,  is  the  only 
proper  method  of  approach  to  the  attempted  solution  of  individual 
cases. 

Meyer  Solomon. 

a beginner’s  psychology.  By  Edward  Bradford  Titchener. 
New  York:  The  Macmillan  Co.,  1913,  $1.00,  pp.  xvi,  362. 

The  two  most  distinctive  features  of  this  book,  which  sup- 
plants but  is  not  a revision  of  the  author’s  earlier  “Primer  of 
Psychology,”  are  the  absence  of  any  description  of  the  nervous 
system,  and  the  great  emphasis  laid  throughout  on  the  distinction 
between  fact  or  process  and  meaning. 

Professor  Titchener  holds,  in  common  with  a minority  of  other 
psychologists,  that  neurology  is  not  a proper  branch  of  psychology, 
and  therefore  should  not  be  included  in  an  elementary  textbook  of 
the  latter  science.  The  reviewer  assents  to  the  first  part  of  this 
statement,  and  wishes  the  teacher  could  assume  in  all  his  students 
that  introductory  knowledge  of  neurology  which  would  make  the 
second  part  of  it  equally  obvious.  A glance  at  the  index,  however, 
shows  at  least  27  distinct  references  to  neurological  topics  (nervous 
“forces,”  “dispositions,”  etc.),  and  the  constant  references  to 
such  matters  throughout  the  book  evidences  at  least  the  difficulty 
of  adhering  with  absolute  consistency,  to  the  principle  of  a pure 
psychology  in  an  elementary  textbook. 

The  reviewer  questions  also,  while  again  yielding  a hearty — 
and  in  this  case  an  enthusiastic — adherence  to  Professor  Titchen- 
er’s  principle  of  separation  between  process  and  meaning,  and  his 
contention  that  psychology  has  to  do  entirely  with  the  former 
and  not  at  all  with  the  latter — -notwithstanding  all  this,  the  re- 
viewer finds  himself  seriously  questioning  the  possibility  of  making 
this  distinction  clear  to  the  elementary  student,  and  maintaining  it 
consistently  throughout  an  entire  course.  The  author  succeeds  in 
this  matter  admirably,  but  at  the  expense  of  sufficient  clearness,  it 
is  to  be  feared,  to  the  student  who  comes  for  the  first  time  to  the 
study  of  non-objective  phenomena.  The  chapter  on  Association, 
for  example,  in  which  the  author  is  most  successful  in  adhering 
to  his  principles,  is  from  the  student’s  point  of  view  probably  the 
least  satisfactory  in  the  book. 

The  concluding  chapter  and  the  appendix  are  devoted  to 
topics  usually  and  probably  advisedly,  omitted  in  introductory 
books  on  general  psychology — -one  to  the  subject  of  "Self  and 
Consciousness,”  the  other  to  “Dreaming  and  Hypnosis.”  1 he 
former,  granting  the  advisability  of  including  these  subjects  at 
all,  is  commendable  for  its  treatment  of  consciousness  and  of  the 
self  of  experience,  though  hardly  just  to  the  concept  of  the  sub- 
conscious in  its  explanatory  aspect. 


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35  7 


Mention  of  the  subconscious  leads  the  reader  naturally  to  a 
consideration  of  the  topics  discussed  by  the  appendix,  which  is 
likely  to  be  the  chapter  of  greatest  interest  to  the  readers  of  this 
Journal.  Why  dreaming  should  be  considered  part  of  the  sub- 
ject-matter of  abnormal  psychology  is  difficult  to  explain,  except 
on  the  ground  that  the  vast  difference  between  the  state  of  con- 
sciousness of  the  dreamer  and  that  of  the  waking  individual  makes 
the  advantageous  elucidation  of  the  mental  processes  of  the  former 
impossible  until  the  waking  processes  have  been  thoroughly  dis- 
cussed and  impressed  upon  the  student,  and  also  that  the  contents 
of  dreams  are  of  wider  significance  for  the  study  of  mental  dis- 
orders than  for  the  understanding  of  the  normal  mental  processes. 
(This  latter,  of  course,  is  but  a relative  difference).  The  chapter 
as  a whole  is  excellent,  considering  the  limitations  of  space.  I note 
only  three  adverse  points — (i)  Is  it  quite  fair  to  state  summarily 
Freud’s  theory  of  dreams  without  defining  the  Freudian  concept 
of  the  “wish,”  and  thus  leave  with  the  reader  an  utterly  foolish 
notion  of  what  “ Freudianism”  teaches?  (p.  341).  (2)  Though 

admitting  that  “the  symptoms  of  hypnosis  do  not  follow  any 
stereotyped  pattern,”  the  author  sticks  pretty  closely  in  the  same 
paragraph  to  the  classic  three  stages  of  Charcot  (p.  342).  (3) 

The  main  symptoms  of  hypnosis  are  said  to  include  anaesthesia 
and  amnesia  (p.  342)  but  no  definition  of  these  terms  is  given 
anywhere  in  the  book. 

Finally,  one  or  two  random  criticisms.  The  subject  of  Interest 
is  fundamentally  interwoven  with  that  of  Attention  in  all  of  its 
phases,  and  yet  is  almost  entirely  ignored  in  the  chapter  devoted 
to  the  latter — surely  a most  unfortunate  omission.  The  questions 
at  the  close  of  each  chapter,  as  is  usually  the  case  in  textbooks, 
are  in  many  instances,  especially  in  the  early  portion  of  the  book, 
quite  useless  to  the  student  or  teacher.  What  reply,  for  example, 
of  any  value  whatever  to  the  student,  could  be  looked  for  to  the 
questions  at  the  end  of  the  introductory  chapter  on  the  nature  of 
science,  the  definition  of  psychology  (most  pressing  of  all  the 
problems  of  that  science  today),  or  the  history  of  human  thought? 
The  conversational  style  of  the  book,  though  estimable  in  intention, 
does  not  always  seem  appropriate  to  the  subject-matter,  and  the 
too  frequent  use  of  marks  of  exclamation  is  decidedly  disconcerting. 
On  the  whole,  as  is  the  way,  unfortunately,  with  revisions  of  earlier 
books,  the  “ Beginner’s  Psychology”  is  not  as  good  as  the  “ Primer,” 
and  one  could  wish  that  the  author  had  not  notified  us  that  the 
latter  will  not  be  further  revised. 

Jared  S.  Moore. 

THE  RELIEF  OF  PAIN  BY  MENTAL  SUGGESTION.  By  Loving  W. 

Batten , A.B.,  Ph.D.,  S.  T.  D.  New  York:  Moffat,  Yard  & Co., 
1917,  $1.25  net,  pp  157. 

The  first  portion  of  this  book  is  devoted  to  an  interpretation, 
based  upon  modern  advances  in  abnormal  psychology,  of  the 


358 


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healing  miracles  as  described  in  the  New  Testament.  Dr.  Batten 
takes  the  logical  stand,  that  most  of  the  disorders  there  described, 
were  functional  neuroses  and  hence  yielded  rapidly  to  psycho- 
therapy. 

The  remainder  of  the  book  is  devoted  to  an  account  of  his 
personal  experience  with  psychotherapy,  strong  emphasis  being 
laid  upon  the  moral  and  religious  elements. 

Unfortunately  Dr.  Batten  has  not  placed  sufficient  stress 
upon  religion  as  a form  of  emotional  sublimation  in  the  psycho- 
analysis of  the  neuroses,  a field  in  which  Pfister  has  made  a nota- 
ble contribution.  On  the  whole,  however,  the  book  is  a most 
sound  and  instructive  contribution  to  the  moral  and  religious 
forces  in  psychotherapy. 

ISADOR  H.  CORIAT. 

nervous  children.  By  Beverley  R.  Tucker , M.  D.  Boston: 
Richard  G.  Badger,  1916,  $1.25,  pp.  147. 

The  first  four  chapters  of  this  book  undertake  to  give  a resume 
of  the  field  of  psychology  and  psycho-biology;  then  come  Eugenics 
and  sex-hygiene;  and  lastly  there  are  five  chapters  treating  of 
nerve  and  gland  diseases,  a little  of  their  symptomatology,  and 
very  cursorily  their  nervous  concomitants  and  treatment.  It 
cannot  be  said  that  this  large  and  interesting  promise  of  the  Table 
of  Contents  is  very  satisfactorily  fulfilled. 

The  psychology  is  treated  from  a rather  antiquated  point  of 
view,  and  the  anatomy  and  physiology  are  described  in  a technical 
terminology  which  will  surely  be  confusing  and  cryptic  to  that 
general  public  to  which  the  book  seems  to  be  addressed.  Very 
much  is  made  of  the  Will  and  of  Self-Control:  the  youth  must 
learn  “to  wear  the  harness  of  Conventionality,”  and  “Obedience 
is  the  Prime  Law  of  Childhood.”  There  is  nothing  on  the  guid- 
ance, expansion,  and  strengthening  of  the  child's  own  natural 
interests  and  desires.  The  fundamental  advance  in  this  direction 
which  has  been  made  by  modern  educational  methods  is  every- 
where ignored  in  favor  of  the  purely  “disciplinary”  attitude  of 
the  older  thought.  The  mechanism  of  suppression,  with  its  grave 
dangers  and  ardently  sought  antidotes,  is  overlooked,  although 
rmearkably  enough,  the  author  professes  to  be  in  some  degree  a 
Freudian.  As  in  too  many  books  of  the  day,  there  is  a generous 
sprinkling  of  platitudes,  such  as  the  recommendation  that  tasks 
be  alloted  in  accordance  with  the  nervous  abilities  of  the  child. 

In  the  treatment  of  sex  and  eugenics  the  all-importance  of 
the  germ-plasm  is  certainly  exaggerated;  although  it  is  true  that 
the  author  also  emphasizes  the  importance  of  careful  sex-educa- 
tion, and  deplores  bad  environmental  influences.  A fatuous 
picture  is  drawn  of  the  cold-blooded,  heartless  progeny  which  are 
to  be  the  fruit  of  purely  eugenic  marriages.  A baby  born  out  of 
wedlock,  we  are  told,  “might  or  might  not  inherit  a sensual  na- 
ture.” 


Reviews 


359 


Finally,  the  synopsis  of  the  basic  diseases  is  dry  and  of  doubt- 
ful utility.  It  is  too  slight  for  the  initiated,  and  the  uninitiated 
person  who,  on  the  strength  of  this  synopsis,  should  do  anything 
but  call  a doctor  would  be  unfortunate  indeed. 

Lawrence  S.  Kubie. 

“The  Gables,”  Wave  Crest,  Far  Rockaway, 

Long  Island,  New  York. 


WAR  BULLETINS 


The  American  Medical  Editors’  Association  which  is  co-op- 
erating with  the  Surgeon  General  in  issuing  information  to  the 
medical  profession  sends  to  the  Journal  the  following  Bulletins: 

(1)  The  Doctor’s  Contribution 

In  this  world’s  war,  your  service  is  absolutely  essential. 

The  medical  officer  bears  the  same  relative  position  in  war  as 
in  peace  in  that  he  is  a conservator  of  health  and  life. 

Through  his  skill,  thousands  of  men  receiving  slight  casualties, 
are  returned  to  the  fighting  force,  thus  conserving  the  physical 
strength  of  the  army. 

In  Base,  Field  and  Evacuation  hospitals,  doctors  are  as  essen- 
tial as  in  civil  institutions,  where  the  sick  and  injured  are  cared 
for. 

As  regimental  surgeons  and  on  transports  and  in  the  Sanitary 
Corps,  must  the  Government  have  doctors  if  we  are  to  terminate 
this  war  successfully. 

Your  contribution  to  your  country  at  this  critical  time  is 
your  service  which  you  can  give  for  the  period  of  the  war  as  an 
officer  in  the  Medical  Reserve  Corps.  That  your  country  needs 
you,  is  best  answered  in  that  she  is  calling  you  now. 

The  fighting  forces  are  constantly  expanding  and  such  ex- 
pansion calls  for  additional  doctors  and  even  with  the  troops  now 
in  training  and  under  mobilization  (about  two  million)  the  Surgeon 
General  has  not  enough  doctors  to  fill  the  requirements. 

Secure  an  application  blank  at  once;  fill  it  out  and  present  it 
to  your  nearest  Examining  Board.  Do  not  live  to  regret  that  you 
did  not  have  a part  in  your  country’s  great  struggle  for  democracy 
which  means  Liberty. 

(2)  To  Officers  of  the  Medical  Reserve  Corps 
U.  S.  Army  Inactive  List 

Word  received  from  the  Surgeon  General  of  the  U.  S.  Army, 
conveys  the  information  to  officers  of  the  Medical  Reserve  Corps 
of  the  United  States  Army,  inactive  list,  that  assignment  to  active 
duty  maybe  delayed, and  that  they  are  advised  to  continue  their 
civilian  activities,  pending  receipt  of  orders.  They  will  be  given 
at  least  15  days  notice  when  sendees  are  required. 


360 


THE  JOURNAL  OF 
ABNORMAL  PSYCHOLOGY 


VOL.  XII  FEBRUARY,  1918  NUMBER  6 

ORIGINAL  ARTICLES 

SUGGESTIONS  REGARDING  A MODIFIED  PSYCHO- 
ANALYSIS1 

E.  W.  Taylor,  M.  D. 

Hysterical  Blindness 

ON  March  23,  1916,  a woman  of  23  was  referred  to  the 
Neurological  Department  of  the  Massachusetts 
General  Hospital  from  the  Massachusetts  Eye  and 
Ear  Infirmary  with  the  simple  statement  “sudden 
blindness;  fundi  do  not  account  for  the  blindness.”  The 
patient  was  led  in  by  a man  who  proved  to  be  her  husband. 
He  was  somewhat  timid  in  manner  and  apparently  alarmed 
about  the  situation  of  his  wife.  The  patient  walked  with 
an  uncertain  gait;  her  face  was  expressionless,  due  largely 
to  the  appearance  of  her  eyes  which  showed  absolutely  no 
intelligence;  she  evidently  was  not  conscious  of  her  sur- 
roundings sufficiently  to  make  it  possible  for  her  to  walk 
unaided.  Her  whole  appearance  expressed  extreme  de- 
jection and  discouragement. 

The  story  obtained  from  her  and  her  husband  at  this 
and  subsequent  visits  was  essentially  as  follows:  She  had 

been  well  as  a child;  her  appendix  had  been  removed  at 
sixteen  without  complications.  She  had  been  at  High 
School  for  three  years  and  did  well  in  her  studies.  At 
seventeen  she  went  to  work  as  a clerk  in  a telephone  ex- 

1 Presented  at  the  Eighth  Annual  Meeting  of  the  American  Psychopatholog- 
ical  Association,  Boston,  May  24,  1917 

Copyright  1918,  by  Richard  G.  Badger.  All  Rights  Reserved- 

361 


362  Suggestions  Regarding  A Modified  Psychoanalysis 

change.  At  the  end  of  six  months  she  began  to  answer  calls. 
She  enjoyed  the  work  and  was  well,  happy  and  enthusiastic. 
At  the  end  of  two  years  she  was  promoted  to  the  position  of 
supervisor,  then  to  chief  operator.  At  this  time  she  had,  as 
she  expressed  it  “sixty  girls  under  her.”  Thereafter  she 
became’  a long  distance  toll  inspector.  Later  still  she  had 
charge  of  a telephone  exchange  at  a large  hotel.  During 
all  this  period  she  felt  a certain  natural  satisfaction  in  her 
success  and  was  earning  a considerable  amount  of  money, 
for  which  she  found  use,  among  other  things,  in  helping  one 
of  her  sisters  to  secure  an  education.  Her  mother  had  had 
an  apoplectic  stroke  two  or  three  years  before  which  some- 
what complicated  the  family  situation.  In  1911  she  had 
pain  in  her  left  ear  with  discharge  and  was  operated  on  for 
mastoid  disease  three  years  later,  in  general  with  good 
result,  but  with  persistent  intermittent  discharge. 

During  her  period  of  activity  in  the  telephone  service 
she  had  had  more  than  one  offer  of  marriage,  but  had  not 
considered  them  seriously  owing  to  her  extreme  interest  in 
her  work  and  the  independence  which  it  brought  her. 
Later,  however,  led  apparently  by  a feeling  of  pity  for  some 
family  misfortune  which  had  happened  to  him,  she  married 
a man  apparently  of  irreproachable  character  who  felt 
himself  able  to  support  her  irrespective  of  her  own  efforts. 
The  result  was  that  she  at  once  gave  up  her  work  and  began 
to  keep  house.  Her  husband  naturally  was  away  during 
the  day  and  she  developed  a sense  of  extreme  loneliness. 
Although  not  consciously  unhappy,  she  felt  dissatisfied  and 
disliked  the  city  in  which  she  was  forced  to  live.  She  be- 
came irritable,  was  easily  annoyed  and  found  it  difficult  to 
get  on  amicably  with  her  husband  and  with  her  mother,  who, 
however,  did  not  live  with  her.  She  did  not  care  for  sewing, 
nor  for  domestic  matters  in  general.  She  had  no  children, 
which  was  a distinct  disappointment  to  her.  A suggestion 
on  her  part  that  she  should  go  back  to  work  met  with  no 
encouragement  from  her  husband.  She  became  increasingly 
apprehensive  and  frightened.  She  dreaded  the  coming  of 
each  new  day;  the  monotony  of  her  life  was  depressing  to 
her  and  her  husband  ceased  to  interest  her  although  she  still 


E.  W.  Taylor , M.  D. 


363 


had  no  word  of  reproach  for  him  and  was  entirely  loyal  to 
the  marriage  relation.  She  stated,  however,  very  definitely 
that  she  would  under  no  circumstances  have  married  had 
she  realized  what  it  had  proved  to  be,  at  the  same  time  ex- 
pressing a determination  to  accept  the  situation  for  which 
she  had  only  herself  to  blame. 

In  March  1915,  following  an  attack  of  vertigo,  possibly 
connected  with  her  ear,  she  fell  down  stairs,  striking  the  left 
side  of  her  chest.  She  was  lame  and  the  skin  was  discolored, 
but  she  was  not  seriously  hurt.  Her  statements  varied  as 
to  her  recovery  from  this  somewhat  trifling  accident.  At 
one  time  she  made  the  statement  that  she  was  unconscious 
for  a number  of  hours,  at  another  that  her  vision  was  dim- 
med for  two  or  three  days  On  a later  occasion  while  looking 
out  the  window,  she  saw  a woman  struck  by  falling  snow. 
She  became  nauseated  and  vomited. 

Vertigo  again  developed,  objects  “turned  black”  and 
she  fell  without  hurting  herself.  It  is  doubtful  whether  she 
lost  consciousness  although  the  immediately  subsequent 
events  are  not  clear  in  her  memory.  Later  she  found  herself 
in  a chair  and  her  husband  was  in  the  room,  but  she  was 
totally  blind.  This  occurred  about  three  weeks  before  she 
presented  herself  at  the  hospital.  It  should  also  be  said 
that  following  her  mastoid  operation  and  preceding  the 
special  events  to  which  allusion  has  just  been  made,  she  had 
had  occasional  attacks  of  what  she  called  “paralysis” 
coming  on  when  she  was  under  any  special  excitement.  On 
these  occasions  her  left  leg  “drew  up,”  her  fingers  were 
clenched,  and  her  head  was  drawn  back  over  her  left  shoul- 
der. There  was  also  a somewhat  vague  statement  that  on 
occasions  she  had  had  loss  of  sight  for  a few  hours.  No 
evidence  was  obtained  that  this  was  associated  with  migraine. 

The  first  examination  made  showed  an  entirely  normal 
fundus  with  practically  no  vision  except  a slight  capacity  to 
distinguish  light  from  dark.  This  had  remained  unchanged 
for  a period  of  three  weeks  in  spite  of  visits  to  various  physi- 
cians who  had  not  been  able  to  relieve  the  situation.  The 
pupils  reacted  to  light,  the  knee  jerks  were  active,  there  was 
no  Babinski  response.  There  was  marked  diminution  of 


364  Suggestions  Regarding  A Modified  Psychoanalysis 

sensation  of  the  glove  and  stocking  type.  The  sensation 
was  also  reduced  in  the  left  eyelid  and  over  an  area  on  the 
left  shoulder  and  side  of  the  neck.  She  stated  that  her 
eyes  “felt  hard,  like  stones.”  There  was  a slight  internal 
squint  on  her  second  visit  and  at  that  time  also  the  right 
knee  jerk  was  rather  more  active  than  the  left.  Sensation 
of  the  hands  had  returned  There  was  no  Romberg  sign. 
A still  later  examination  gave  the  following  normal  results: 
Pupils  equal,  rather  small,  normal  light  and  accommodative 
response.  Fields  (by  rough  test)  and  fundus  normal.  No 
nystagmus.  Was  able  to  follow  fingers  perfectly.  Hearing; 
watch  tick  4 inches,  left,  1 foot,  right,  with  positive  Rinne 
test.  Defect  in  left  ear  drum.  Cranial  nerves  normal  and 
tongue  normal.  The  arms  showed  no  ataxia;  there  w'as  no 
disturbance  of  sensation  or  motion  and  the  reflexes  were 
normal.  Dynamometer  showed  strength  approximately 
three  times  as  great  on  the  right  as  on  the  left.  The  heart 
was  negative,  pulse  68,  blood  pressure  120  systolic,  75  dias- 
tolic. The  liver  was  not  enlarged  and  the  abdomen  was 
normal.  The  knee  jerks  were  active,  there  was  no  ankle 
clonus,  a normal  Achilles  response,  the  plantar  reflex  in- 
definite on  account  of  ticklishness,  the  sense  of  position  unim- 
paired. She  had  no  difficulty  in  walking.  There  was  no 
Romberg  sign. 

Restoration  of  sight  was  carried  out  at  the  hospital  in 
the  presence  of  a number  of  students.  Improvement 
began  almost  immediately.  On  her  second  visit  she  was  able 
to  distinguish  her  hand,  but  could  not  count  fingers.  A 
day  or  two  later  she  was  able  to  distinguish  persons  easily 
and  many  objects  and  her  face  began  to  assume  a normal 
expression.  One  week  after  admission  to  the  hospital  her 
eyesight  was  completely  restored  and  the  following  day  she 
was  discharged  with  entire  relief  of  her  symptoms  and  with 
entirely  adequate  visual  fields,  her  acuity  of  vision  being 
such  that  she  had  no  difficulty  whatever  in  reading  type  of 
the  newspaper  size. 

The  treatment  in  this  case  consisted  first  in  restoring 
the  sight,  which  was  accomplished  with  unexpected  ease  by 
rather  crude  methods  of  suggestion  and  explanation.  It  was 


E.  IV.  Taylor , M.  D. 


365 


explained  to  her  that  she  had  not  actually  lost  the  capacity 
of  seeing  and  she  was  encouraged  day  by  day  to  recognize 
large  objects,  then  to  count  the  number  of  persons  standing 
about,  to  distinguish  their  white  coats,  etc.,  all  aided  by 
electricity  variously  applied.  This  as  stated  was  done  in 
the  presence  of  students  and  others.  By  these  means  her 
sight  was  entirely  restored  and  with  it  a feeling  of  extreme 
satisfaction  and  well-being.  The  subsequent  treatment,  by 
far  the  more  important,  was  not  attempted  at  the  hospital. 
Two  or  three  conversations  sufficed  to  bring  out  the  main 
points  in  her  life  story  which  have  already  been  hinted  at  in 
the  history  above  and  which  may  be  summarized  as  follows: — 
It  appeared  that  she  was  an  extremely  ambitious  and  capable 
girl  who,  judged  by  ordinary  standards,  and  especially  by 
her  own,  had  been  unusually  successful  in  acquiring  personal 
independence  and  a considerable  income.  Her  pride  was 
further  satisfied  in  that  she  had  attained  a position  in  which 
she  had  charge  of  many  other  persons.  Other  thoughts 
than  her  individual  development,  especially  the  gratifying 
sense  of  power  that  she  was  able  to  help  others  of  her  family, 
had  taken  a prominent  place  in  her  mind.  She  was  attrac- 
tive in  appearance  and  manner  and  flattering  opportunities 
for  marriage  had  presented  themselves  which  she  discarded 
because  of  her  absorbing  interest  in  her  work  and  her  failure 
to  arouse  in  herself  any  feeling  of  regard  for  the  men  who 
offered  themselves.  This  state  of  affairs  was  rather  suddenly 
terminated  by  the  appearance  on  the  scene  of  the  man  who 
later  became  her  husband.  He  forthwith  appealed  to  her 
in  a way  which  she  was  unable  either  to  resist  or  explain 
although  his  position  in  life  was  far  less  advantageous  than 
that  of  others  who  had  gone  before.  She  married  him,  gave 
up  her  cherished  work  at  his  somewhat  natural  demand  and 
her  disillusionment  soon  began.  He  proved  to  be  an  entirely 
faithful  husband  and  according  to  his  ideas,  generous,  but 
he  was  small-minded  and  developed  a jealous  attitude  which 
limited  still  more  her  life  and  companionship.  This  jealousy 
showed  itself  not  only  in  relation  to  other  men  in  whom  she 
at  no  time  had  the  slightest  interest,  but  also  in  relation  to 
her  work.  She  submitted  without  outward  resistance  and 


366  Suggestions  Regarding  a Modified  Psychoanalysis 

accepted  the  situation  with  such  equanimity  as  she  could 
command  although  inwardly  rebellious  and  consequently 
always  repressed.  She  lived  in  a rather  gloomy  house,  she 
was  unadaptable,  her  loneliness  and  increasing  realization 
of  what  she  had  given  up  was  a constant  source  of  chagrin. 
She  recognized,  however,  that  she  alone  was  responsible  for 
her  marriage  and  had  no  intention  of  any  illegitimate  escape 
from  this  responsibility.  The  one  thing  which  would  have 
rendered  her  life  endurable  was  denied  her.  She  had  no 
children.  Under  these  conditions,  her  husband  came  very 
naturally  to  be  regarded  as  the  source  of  her  misfortune. 
Her  affection  for  him  entirely  ceased.  She  was  unable  to 
affect  a workable  compromise  with  the  circumstances  of 
her  life,  a situation  which,  as  always,  expressed  itself  in  symp- 
toms for  which  she  did  not  consciously  blame  her  husband 
although  he  became  increasingly  distasteful  to  her.  Her 
marriage  she  regarded  as  a failure,  a hasty  step  which  she 
certainly  would  not  have  taken  had  she  realized  what  the 
outcome  would  be.  Out  of  this  conscious,  but  even  more 
unconscious  trouble,  she  emerged  blind  on  the  occasion  of  a 
slight  accident  which  she  saw  in  the  street,  her  husband 
being  in  the  room  at  the  time. 

Without  any  attempt  at  a further  analysis  of  the  situa- 
tion the  underlying  psychological  mechanism  was  explained 
to  her  in  language  which  she  apparently  had  no  difficulty  in 
understanding.  She  recognized  the  reasonableness  of  this 
explanation  even  to  the  point  that  the  blindness  might  well 
be  regarded  as  a futile  but  at  all  events  a temporarily 
successful  attempt  on  the  part  of  her  consciousness  to  shut 
out  permanently  the  real  source  of  her  unhappiness,  namely 
her  husband. 

It  is  now  nearly  two  years  since  her  attack.  During 
that  period  she  has  spent  much  of  her  time  with  her  mother 
who  had  a lingering  and  trying  illness  as  the  outcome  of  an 
apoplectic  stroke,  and  who  died  several  months  ago,  nursed 
to  the  end  by  her  daughter.  She  is  now  again  with  her 
husband,  from  whom  she  has  at  no  time  been  permanently 
separated,  and  apart  from  considerable  general  nervousness 
and  a continued  sense  of  unfair  and  ungenerous  treatment, 


E.  JV.  Taylor , M.  D. 


367 


she  is  well.  She  has  had  absolutely  no  return  of  the  blind- 
ness and  her  vision  when  last  seen  on  January  17  was  entirely 
normal  by  test  type.  An  admonishing  letter  written  her 
husband  at  the  time  of  her  attack  of  blindness  resulted  in  a 
considerable  modification  of  his  attitude  toward  her,  but 
he  has  remained  unsympathetic  and  entirely  inconsiderate. 
Her  problem,  therefore,  remains  unsettled  and  under  existing 
social  conditions  apparently  must  remain  so,  but  through 
completer  understanding  of  the  genesis  of  her  difficulties 
of  which  the  blindness  was  the  crowning  event,  she  has 
reached  a definitely  workable  compromise. 

Before  attempting  to  justify  this  method  of  treatment, 
which  to  many  will  appear  wholly  superficial,  the  following 
cases  are  reported  as  bearing  on  the  practical  question. 

Case  2.  Hysterical  Brachial  Monoplegia : Ad.  M.  22 

years  old,  a probationer  nurse  .at  a hospital  in  a neighboring 
town,  was  brought  to  me  by  the  superintendent  of  nurses 
at  the  institution  because  the  patient  had  lost  the  use  of  her 
left  arm.  For  two  or  three  days  she  had  noticed  prickling 
sensations  in  the  left  hand.  The  day  before  she  presented 
herself  for  examination,  the  whole  hand  and  the  arm  to  the 
elbow  became  numb  and  weak  with  some  sense  of  soreness 
in  the  shoulder.  She  had  no  temperature  and  had  not  felt 
ill  in  any  way,  nor  had  her  appetite  or  sleep  suffered.  She 
had  had  no  hard  work.  On  two  occasions  before  her  diffi- 
culty came  on,  she  had  for  the  first  time  attended  a surgical 
clinic  and  was  very  much  disturbed  by  the  sight  of  blood 
and  the  circumstances  connected  with  the  operations.  She 
had  taken  part  in  cleaning  the  operating  room  later. 

The  patient  appeared  unperturbed  in  manner  and  not 
anxious  about  herself  or  her  condition.  Her  pupils  and 
hearing  were  normal,  and  there  was  no  disorder  of  the 
cranial  nerves.  The  right  arm  showed  no  abnormality 
either  in  sensation  or  motion  nor'was  there  ataxia  or  astere- 
ognosis.  The  left  arm  was  anesthetic.  Beginning  at  the 
upper  part  of  the  upper  arm  the  anesthesia  increased  down- 
ward to  complete  loss  of  sensation  from  a point  about  the 
middle  of  the  forearm  and  including  the  hand.  The  arm 
was  extremely  ataxic.  There  were  no  perception  of  pain, 


368  Suggestions  Regarding  a Modified  Psychoanalysis 

contact  or  temperature  in  the  anesthetic  area  and  she  did 
not  recognize  objects  placed  in  her  hand.  Her  movements 
were  very  awkward.  She  had  no  power  whatever  in  the  left 
hand  as  tested  by  the  dynamometer,  with  normal  grasp  in 
the  right.  There  was  no  pain  on  pressure  over  the  nerve 
trunks.  The  circulation  was  normal  with  a systolic  blood 
pressure  of  130.  The  knee  jerks  were  normal.  An  attempt 
to  use  the  anesthetic  hand  in  an  act  such  as  buttoning  was 
a complete  failure.  The  diagnosis  of  hysteria  was  easily 
made  from  the  distribution  and  character  of  the  anesthesia 
and  from  the  exaggerated  loss  of  power. 

A restoration  both  of  the  motor  and  sensory  loss  was 
quickly  effected  primarily  by  the  use  of  faradism  in  strong 
currents  which  she  quickly  felt.  With  the  return  of  sensa- 
tion the  power  to  coordinate  her  hand  movements  also  re- 
turned together  with  her  strength.  In  a short  time  she  was 
able  to  use  the  hand  normally.  The  further  treatment  and 
again  the  more  important  consisted  in  a simple  explanation 
of  the  mechanism  of  hysterical  disturbances  of  this  type. 
It  was  pointed  out  that  undoubtedly  her  hand  had  come 
into  contact  with  various  objects  such  as  blood-stained 
dressings  which  she  handled  as  she  was  obliged  to  do  in  the 
performance  of  her  duty,  but  which,  nevertheless,  left  a dis- 
tinctly painful  impression  upon  her  mind.  Of  such  supposed 
facts  she  was  not  personally  conscious,  but  believed  that 
such  a state  of  affairs  probably  existed.  It  was  pointed  out 
to  her  that  under  these  circumstances,  although  her  con- 
sciousness took  no  cognizance  of  the  fact,  the  anesthesia  and 
loss  of  power  in  the  hand  was  doubtless  a protest  against  this 
sort  of  work,  taking  place  subconsciously.  The  explanation 
was  apparently  effective.  A letter  written  about  two  weeks 
later  from  the  superintendent  of  nurses  reads  as  follows: 
“Miss  M.  since  her  visit  to  your  office,  has  been  quite  free 
from  the  difficulty  which  you  found  that  day.  At  one  time 
she  complained  of  not  being  able  to  sleep  and  had  about  the 
same  condition  of  the  arm,  but  it  cleared  up  quickly  and  she 
had  no  return.”  My  impression  is  that  she  was  later  found 
unfitted  temperamentally  for  the  work  of  a nurse  and  gave 
up  her  training.  Her  subsequent  history  is  not  known  to 
me. 


E.  W.  Taylor , M.  D. 


369 


Case  3.  Astasia-abasia.  B.  W.  a girl  of  15  was  seen 
March  30,  1916.  She  had  been  under  treatment  by  her 
physician  for  about  six  months  for  anemia.  She  had  im- 
proved under  the  usual  treatment.  Recently  she  had  had 
an  attack  of  influenza  with  follicular  tonsillitis  for  which 
she  was  confined  to  bed  for  ten  days.  There  was  also  some 
suspicion  of  appendix  inflammation.  During  her  illness 
she  was  somewhat  unsteady  in  gait,  supposedly  from  general 
weakness  induced  by  her  fever.  When  she  was  able  to  be 
about  again  she  could  not  walk  properly.  She  had  some 
pain  behind  the  knees,  and  in  the  arms.  There  was  no 
numbness  and  she  complained  of  slight  “prickly”  sensations. 
She  said  that  her  knees  shook  and  gave  way  under  her,  and 
that  she  had  fallen  two  or  three  times  without  injuring 
herself.  She  had  had  much  dysmenorrhea.  It  was  further 
elicited  that  she  had  been  unable  to  go  to  school  for  two 
years  on  account  of  various  illnesses.  This  had  undoubtedly 
been  a great  disappointment  to  her.  On  one  occasion,  when 
starting  for  school  she  found  herself  unable  to  walk  and  had 
to  be  cared  for.  On  further  questioning  it  appeared  that 
she  had  had  so-called  fainting  attacks  for  several  years.  On 
one  of  these  occasions  she  had  been  left  alone  with  a small 
child  of  two.  Her  mother  was  late  in  returning.  It  grew 
dark  and  she  went  into  the  kitchen  with  the  intention  of 
lighting  the  gas.  As  she  was  doing  so  she  felt  dizzy  and  was 
found  by  her  mother  some  time  later  unconscious  on  the 
floor.  Her  dress  was  burned  in  various  places  along  the 
front  and  there  was  a smell  of  burning  cloth.  She  had 
succeeded  in  lighting  the  gas  and  had  apparently  fallen  on 
the  match.  Exactly  how  she  was  burned  was  not  apparent, 
but  she  felt  that  she  had  had  a very  narrow  escape  and  forth- 
with became  morbidly  terrified  with  the  idea  of  fire.  She 
dreamed  about  it,  awoke  terrified  and  it  assumed  almost 
obsessional  character.  She  then  thought  what  a dreadful 
tjhng  it  would  be  if  in  case  of  .fire,  her  legs  should  give  out 
and  she  should  become  unable  to  walk.  This  feeling  had 
been  very  persistent  though  not  often  an  expressed  idea 
with  her.  As  stated  above,  since  her  last  illness,  she  had 
been  totally  unable  to  walk  properly  and  in  her  attempts  to 


370  Suggestions  Regarding  a Modified  Psychoanalysis 

9 

do  so  has  fallen  on  several  occasions.  She  was  physically  a 
well  developed  girl,  both  in  appearance  and  manner  of 
speaking,  appearing  older  than  she  actually  was.  She.  was 
perfectly  self-contained  and  composed  in  manner,  but 
showed  a little  anxiety  at  the  sight  of  medical  instruments. 
The  right  pupil  was  slightly  larger  than  the  left,  but  both  in 
.reaction  to  light  and  on  accommodation  were  normal.  The 
fields  were  not  narrowed  and  the  fundus  was- normal.  There 
was  no  nystagmus.  She  had  no  defect  of  hearing.  The 
tongue  was  slightly  coated,  the  tonsils  rather  large  and 
boggy.  There  was  no  anesthesia  about  the  face,  nor  were 
the  cranial  nerves  in  any  way  involved.  The  arms  showed 
no  ataxia  nor  anesthesia.  The  strength  was  adequate,  pulse 
108,  systolic  pressure  130,  heart  normal.  The  knee  jerks 
were  active.  The  Achilles  jerks  were  present  and  active, 
there  was  no  ankle  clonus  and  no  Babinski  response.  The 
sciatic  nerves  were  not  tender  on  pressure  and  there  was  no 
anesthesia  of  the  legs  or  feet.  When  sitting  she  was  able 
to  make  all  movements  with  her  feet  and  legs  in  entirely 
normal  fashion,  but  was  utterly  unable  to  stand  alone. 
When  attempting  to  do  so  she  reeled  in  various  directions, 
and  apparently  had  no  power  whatever  of  co-ordination. 
Her  attempts  to  walk  were  equally  impossible.  With  a 
great  deal  of  support  she  dragged  herself  about,  shuffling  her 
feet  and  taking  no  proper  steps.  When,  however,  she  was 
placed  against  a support  at  the  back  with  her  hands  on  a 
chair  on  either  side,  she  was  able  to  make  co-ordinated 
stepping  movements. 

Without  attempting  any  special  analysis  of  this  case 
it  is  sufficiently  apparent  that  her  astasia-abasia  Avas  due 
to  a series  of  ideas  associated  with  her  accident  and  conse- 
quent fear  of  fire.  The  dissociation  of  this  particular  com- 
plex had  been  effectually  established  and  stimulated  by  the 
natural  weakness  of  her  febrile  illness,  had  asserted  itself 
as  a definite  disturbance  of  gait  which  persisted  after  her 
recovery  from  this  illness. 

Here  again  a simple  explanation  of  the  situation  suited 
to  the  girl’s  understanding  resulted  in  an  immediate  marked 
improvement  in  her  condition  and  a recovery  of  normal 


E.  W.  Taylor , M.  D. 


37i 


locomotion  within  two  days.  About  a year  and  a half  after- 
ward she  was  reported  as  well  and  with  no  return  of  her 
incapacity. 

The  foregoing  cases  are  not  reported  for  their  rarity; — 
they  represent  merely  well  defined  types  of  hysterical  con- 
versions— but  rather  to  draw  attention  to  certain  Vvery 
practical  details  of  psychotherapeutic  procedure.  There  is 
no  question  that  psychotherapy  has  finally  been  accepted  as 
a legitimate,  useful  and  often  indispensable  therapuetic 
measure.  The  term  has  found  its  way  into  text-books  and 
has  taken  its  place  with  the  traditional  methods  of  medical 
treatment.  There  it  will  doubtless  remain,  but  it  is  still 
far  from  having  obtained  anything  like  its  due  recognition 
as  a method  worthy  of  general  adoption  by  unspecialized 
practitioners.  How.  it  should  be  used  as  a scientific  and 
rational  means  of  attaining  certain  ends  is  still  almost 
wholly  undetermined  in  the  general  medical  mind. 

It  is  my  purpose  very  briefly  to  point  out  certain  difficul- 
ties in  the  way  of  its  general  adoption  which  are  perhaps 
worthy  of  more  attention  than  they  have  yet  received.  In 
the  development  of  any  therapeutic  procedure  which  lays 
claim  to  general  acceptance,  it  is  obvious  that  two  tendencies 
must  always  be  in  evidence,  first  research  and  the  establish- 
ment of  principles  and  secondly,  the  application  of  those 
principles  in  a way  which  will  be  understandable  and  which 
will  appeal  to  the  common  sense  judgment  of  the  ordinary 
man.  Out  of  the  confusion  of  conflicting  opinions  must 
finally  be  evolved  methods  which  are  simple  of  employment 
in  the  hands  of  persons  of  ordinary  medical  intelligence. 
If,  therefore,  rational  psychotherapy  is  to  be  widely  accepted, 
it  must  present  methods  which  are  workable  and  which  are 
fruitful  in  results.  Research  and  the  establishment  of 
principles  are  going  on  apace.  Regarding  this  aspect  of  the 
subject  we  need  have  no  concern.  The  controversial  ten- 
dencies of  the  pioneers,  futile  as  they  may  appear,  are  at 
at  least  an  indication  of  the  vitality  of  the  discussion  and 
should  not,  therefore,  be  too  much  condemned.  More  im- 
portant for  those  who  are  attempting  to  practice  and  es- 
pecially to  teach  a rational  psychotherapy  is  the  recognition 


372  Suggestions  Regarding  a Modified  Psychoanalysis 

of  the  principles  from  whatsoever  source  derived,  which  have 
up  to  this  time  resulted  from  the  heat  of  the  discussion, 
without  undue  insistence  on  differences  of  opinion  or  ter- 
minology. 

It  will,  no  doubt,  be  generally  acknowledged  that  the 
influence  of  the  newer  ideas,  associated  particularly  with  the 
analytical  principle  has  been  fundamentally  important  in 
the  interpretation  of  symptoms,  nor  is  it  open  to  doubt  that 
even  the  skeptics  and  active  opponents  of  the  psycho- 
analytical method  are  distinctly  affected  by  its  permeating 
influence  in  spite  of  iheir  protestations.  There  is  a very 
definite  appeal  to  commonsense  in  the  term  “psycho- 
analysis” and  in  the  interests  of  progress  it  should,  so  far 
as  possible,  be  divested  of  the  controversial  atmosphere 
which  surrounds  it  and  impairs  its  usefulness.  The  term 
“evolution”  will  always  be  associated  with  the  name  of 
Darwin,  as  psychoanalysis  will  be  with  that  of  Freud,  but 
in  the  one  case  as  in  the  other,  both  terms  are  of  too  far- 
reaching  significance  to  be  circumscribed  by  the  theories  of 
their  originators.  We  are  too  apt  to  think  that  if  we  con- 
sider ourselves  psychoanalysists  we  are  thereby  bound  to 
the  exact  method  which  brought  the  term  into  prominence. 
It  is  regarded  as  heretical  and  retrograde  to  depart  from 
the  doctrine  which  has  been  scrupulously  outlined  as  the 
one  correct  method  of  procedure.  This  attitude  will  not 
help  the  general  cause. 

It  seems  altogether  unlikely,  and  in  fact  undesirable 
that  psychoanalysis  as  understood,  by  its  chief  promulgators 
will  ever  have  a universal  application  for  the  following  some- 
what obvious  reasons.  First  the  technic  is  too  elaborate  to 
be  practically  useful  except  in  relatively  few  selected  cases. 
Secondly,  there  is  distinct  danger  to  the  welfare  of  the  patient 
unless  the  analysis  is  carried  to  its  conclusion  which  is  fre- 
quently impossible  and  thirdly,  even  if  this  were  possible, 
it  is  often  not  necessary  or  even  desirable.  I am  quite  aware 
that  to  use  the  term  psychoanalysis  in  any  other  sense  than 
that  which  Freud  and  his  immediate  followers  have  estab- 
lished will  meet  with  distinct  opposition.  Nevertheless  modi- 
fications must  be  made  in  the  interest  of  a broader,  practical 
therapeutic  outlook. 


E,  W.  Taylor , M.  D. 


373 


To  meet  this  difficulty  I have  elsewhere  suggested  the 
use  of  the  term  “partial  or  incomplete  psychoanalysis  or 
perhaps  better  “modified  psychoanalysis,”  by  which  is 
meant  simply  an  application  of  the  general  principles  in 
modified  form  to  meet  the  requirements  of  individual  cases. 
A rational  therapeutic  attempt  demands  above  all  things 
that  we  should  not  leave  our  patient  in  a worse  condition 
than  we  found  him.  He  may  not  be  improved;  this  is  a 
common  experience  and  deserving  of  .no  reproach  if  our 
effort  is  sincere,  but  we  should  certainly  guard  as  far  as  may 
be  against  complicating  still  further  an  already  complicated 
situation.  My  impression  is  that  the  “complete  psycho- 
therapist,” if  I may  so  call  him,  not  infrequently  finds  him- 
self in  this  dilemma  through  his  too  blind  adherence  to  the 
rule  of  thumb  method.  He  lacks  imagination,  a dangerous 
failing  in  one  who  deals  with  the  subtleties  of  the  human 
mind. 

The  compromise  I have  to  suggest  lays  no  claim  to  ori- 
ginality. It  is  rather  an  appeal  to  commonsense  and  it  has 
at  least  some  value  since  it  seems  to  work.  Why  may  we 
not  accept  in  a general  way  the  psychoanalytical  view  point, 
the  doctrines  of  repression,  conflict,  compromise,  censor, 
regression,  infantile  fixation  and  any  or  all  of  the  other  useful 
concepts,  but  so  modify  the  technique  of  their  application 
that  we  may  escape  the  pitfalls  of  transference  and  the 
time-consuming  method  of  free  association.  Such  a taking- 
and-leaving  plan  will  not  find  favor  with  the  orthodox,  nor 
do  I maintain  that  it  should  supercede  the  elaborated 
technique.  What  value  it  may  have  lies  in  the  fact  that  it 
has  a far  wider  applicability  and  is  beset  with  few  of  the 
dangers  of  the  complete  method. 

Following  out  this  idea,  it  has  been  my  custom  often  at 
a first  and  certainly  at  the  second  interview,  to  take  the 
patient  into  my  confidence  by  explaining  exactly  what  I 
intend  to  do  and  the  methods  by  which  it  is  to  be  accom- 
plished— in  other  words,  forthwith  to  make  the  patient  a 
participant  in  his  own  treatment.  All  mystery  is  laid  aside, 
the  reclining  chair,  the  hypnoidal  attitude  of  mind,  and  all 
the  methods  designed  to  arouse  dormant  memories  through 


374  Suggestions  Regarding  a Modified  Psychoanalysis 

free  association  are  abolished  in  the  interests  of  candor  and 
immediate  explanation.  For  somewhat  theatrical  methods 
are  substituted  a plain  statement  of  the  patient’s  difficulties 
and  an  equally  plain  statement  modified  to  meet  his  grade 
of  intelligence  of  the  theory  of  subconscious  activities,  of 
repression,  conflict,  compromise  and  the  like  and  particu- 
larly of  the  mechanism  of  the  genesis  of  symptoms. 

It  is  a safe  assumption  that  the  first  principle  of  success- 
ful teaching  is  the  exciting  of  interest  in  the  subject  taught. 
Since  mental  therapy  is  a form  of  teaching,  it  is  desirable 
that  the  patient  should  be  made  to  feel  an  interest  in  the 
method  as  well  as  in  the  results.  Something  is  doubtless 
lost  or  obscured  in  such  a short-cut  to  self  revelation,  but  in 
very  many  cases  results,  and  I believe  permanent  results,  are 
secured  and  much  more  quickly  than  by  more  orthodox 
methods  of  analysis.  In  each  of  the  cases  which  form  the 
basis  of  this  communication,  the  treatment  attempted  was 
direct  and  immediate  results  of  value  were  obtained.  It 
may  be  said  that  the  symptoms  in  these  cases  will  return  in 
the  same  or  other  forms  and  that  merely  the  surface  of  the 
fundamental  underlying  disorder  was  touched.  In  one 
sense  this  is  doubtless  true,  but  the  value  of  the  treatment 
is  not  compromised  by  this  fact,  nor  can  it  be  definitely 
said  that  a further  research  would  necessarily  have  led  to  the 
betterment  of  their  condition.  The  danger  of  delving  too 
deeply  for  causes  may  well  be  fraught  with  more  harm  than 
not  delving  deeply  enough.  This  point  has  often  been  dis- 
cussed and  unanimity  of  opinion  is  not  likely  soon  to  be 
attained.  My  only  present  contention  is  that  it  is  our 
duty  to  make  the  far-reaching  principles  of  the  newer  psycho- 
logical methods  as  universally  applicable  as  possible  and  to 
accomplish  this  it  is  essential  that  they  should  be  made  usable 
under  the  conditions  which  actually  confront  us  in  dealing 
with  our  patients.  This  is  worth  striving  for,  even  at  the 
risk  of  being  charged  with  superficiality. 


THE  ROLE  OF  THE  EMOTIONS  IN  THE  GENESIS 
OF  INSANITIES 

AND 

INSANITY  FROM  THE  STANDPOINT 
OF  EVOLUTION 

BY  I.  S.  WECHSLER,  M.  D. 

Instructor  in  Neurology,  Columbia  University , New  York. 

Introduction 

EVERY  philosopher,  from  Thales  to  Bergson,  has 
sought  to  explain  the  oneness  of  things.  Psychol- 
ogy, as  the  daughter  of  metaphysics,  nurtured  in  the 
ancient  cradle,  followed  the  beaten  path  and  labored 
with  similar  effort.  But  when  experimental  knowledge 
began  to  crowd  out  deductive  speculation  and  linear  thinking 
replaced  circular  reasoning,  positive  science  came  into  its 
own.  The  principle  of  evolution  which  began  to  dominate 
science  aided  in  this  change.  Abnormal  psychology,  too, 
followed  the  new  trend,  but,  unfortunately,  the  old  tendency 
to  seek  final  causes,  intellectual  monism,  is  evident  in  much 
of  the  present  day  studies  of  psychopathology. 

The  Freudian  theory  is  an  excellent  illustration  of  this 
tendency.  Taking  a powerful,  all-dominating  instinct, 
Freud  and  his  followers  built  a system  around  it  and  sought 
to  reduce  all  abnormal  psychical  manifestations  to  it. 
Having  grasped  one  single  truth  they  tried  to  prove  that  it 
is  the  whole  truth.  Another  writer1,  seizing  upon  another 
all-powerful  instinct,  sought  in  fear  the  root  of  all  patho- 
logical mental  processes.  And  thus  it  goes  on  endlessly. 
Each  one  seems  to  think  that  this  or  that  powerful  influence 
is  dominant  and  forgets  that  other  influences  also  exist, 
or  else  tries  to  subordinate  all  to  one.  But  while  it  is  right 
to  trace  neuroses  and  psychoses  to  disturbance  in  primary 
instincts  and  their  emotions  it  must  be  borne  in  mind  that 

1 Boris  Sidis,  The  Causation  and  Treatment  of  Psychopathic  Diseases. 

375 


376  Role  of  the  Emotions  in  the  Genesis  of  Insanities 

there  are  others  .aside  from  those  of  fear  and  reproduction. 
Normal  psychology,  with  the  advent  of  physiological 
psychology,  has  made  great  strides  in  recent  years;  it  is  the 
object  of  this  paper  to  point  out  how  abnormal  psychology 
may  be  brought  abreast  of  those  advances.  We  shall  not 
attempt  so  much  to  present  novel  views  but  rather  facts 
previously  gathered  pointing  to  a newer  conception.  In  the 
attempt  to  clarify  the  notion  of  insanity  it  shall  be  our  aim 
to  show  that  the  notion  as  an  entity  has  no  foundation  either 
in  normal  or  abnormal  psychology.  Just  as  normal  psy- 
chology has  discarded  the  idea  of  mental  faculties  so  ab- 
normal psychology  must  discard  the  idea  of  insanity  as  an 
entity.  Just  as  we  have  come  to  see  that  there  is  no  memor} 
but  memories,  no  judgment  but  judgments,  no  will  but  wills, 
no  intellect  but  intelligences,  no  consciousness  but  states  of 
consciousness;  so  we  have  no  entity  of  insanity  but  in- 
sanities. It  is  not  the  desire  to  quarrel  with  the  classifica- 
tion of  insanity.  For  clinical  purposes,  as  temporary  make- 
shifts, we  may  employ  the  various  classifications,  but  funda- 
mentally it  must  be  maintained  that  insanity  is  not  an 
entity.  There  is  no  insanity  only  little  bits  of  insanities. 
It  will  further  be  shown  that  all  the  symptoms  of  insanity 
can  be  analyzed  and  reduced  to  terms  of  the  simplest  pri- 
mary emotions.  All  the  psychical  manifestations  of  the 
abnormal  mind  whether  of  the  affective  or  organic  psy- 
choses, or  of  the  psychopathological  states  of  the  so-called 
neuroses,  will  be  shown  to  have  their  root  in  the  disturbance 
of  balance  which  normally  exists  between  the  primary 
elementary  emotions. 

The  second  half  of  this  paper  will  be  devoted  to  the  dis- 
cussion of  insanity  as  a step  in  evolution.  We  consider  the 
insanities  not  in  the  same  class  of  diseases  as  pneumonia  or 
typhoid,2  but  as  a distinct  affection  of  the  species.  In  the 
scheme  of  evolution  insanity  serves  a distinct  and  very 
necessary  function.  It  will  be  maintained  that  insanity  is 
the  direct  result  of  the  constant  struggle  observed  through- 
out nature  between  the  individual  and  the  species.  We 
shall  not  ignore  the  fact  that  the  organic  insanities  are  the 
direct  result  of  anatomico-pathological  states  comparable 
3 Bernard  Hart,  The  Psychology  of  Insanity. 


I.  S.  Wechsler , M.  D. 


377 


to  a typhoid  or  pneumonia.  Without  trying  to  break  a 
lance  in  complete  defense  of  psycho-physical  parallelism  it 
will  be  made  use  of  in  the  explanation  of  the  paradox  which 
the  affective  and  organic  psychoses  present. 

If,  as  can  be  proved,  the  workings  of  the  insane 
mind  are  the  same  as  those  of  the  sane,  then  it  becomes 
obvious  that  from  the  standpoint  of  the  psychology  of  the 
individual,  normal  or  abnormal,  there  is  no  such  thing  as 
insanity.  We  shall  be  compelled  to  look  elsewhere  for  a 
consideration  of  the  disease.  It  is  a disease  of  and  in  the 
social  organism.  It  is  a disease  of  the  individual  resulting 
from  his  struggle  with  species.  It  is  an  evolutionary  pro- 
cess for  the  elimination  of  the  unfit  in  the  struggle  for  exis- 
tence. It  is  a necessary  social  disease,  a true  disease  of  the 
species.  The  criterion  must  be  sought  in  the  species.  And 
just  as  in  the  process  of  evolution  criteria  change  so  do  the 
conceptions  of  insanities  change.  But  underlying  them  all 
is  conflict — the  everlasting  struggle  for  the  survival  of  the 
fittest.  We  shall  attempt  to  show,  therefore,  that  all 
symptoms  of  the  insanities,  of  the  abnormal  workings  of  the 
conscious  and  unconscious  mind,  can  be  reduced  to  terms  of 
loss  or  disturbance  of  the  normal  balance  existing  between 
the  primary  emotions,  and  that  this  loss  or  disturbance 
called  insanity  is  the  direct  result  of  the  struggle  between  the 
individual  and  the  species. 

The  Emotions  and  Insanities 
Many  psychologists  and  most  psychiatrists  speak  in- 
discriminately of  the  instincts  and  emotions,  and  some  there 
are  who  add  the  sentiments  if  not  the  “temperaments,” 
often  employing  one  term  for  another  and  not  infrequently 
confusing  them.3  McDougall4  has  rendered  an  invaluable 
service  to  psychology  by  classifying  the  primary  instincts 
and  emotions,  general  innate  tendencies  and  secondary 
emotions,  and  defining  exactly  the  different  sentiments. 
On  the  latter  he  quotes  Mr.  Shand°  who  has  given  scientific 

3 Even  so  great  a psychologist  as  James  'has  enumerated  some  twenty-five 
instincts  and  has  included  habits  and  sentiments  among  them.  William  James, 
The  Principles  of  Psychology,  Vol.  II. 

WVilliam  McDougall,  Social  Psychology,  9th  Ed. 

5 A.  F.  Shand,  Character  and  the  Emotions,  Mind  N.  S.  Vol.  V. 


378  Role  of  the  Emotions  in  the  Genesis  of  Insanities' 

precision  to  them  and  classified  them  as  distinct  entities 
formed  of,  but  different  from  the  emotions.  McDougall 
defines  an  instinct  as  a psycho-physical  tendency  to  act  or 
to  show  an  impulse  to  act  in  a certain  way,  irrespective  of 
previous  experience,  that  is  from  an  inherited  (phylogenetic) 
disposition;  and  an  emotion  as  the  affective  tone  accom- 
panying the  instinct.  Each  instinct  has  its  accompanying 
emotional  tone.  A sentiment  is  a group  of  emotions  centered 
about  an  object  and  forming  a complex.  In  this  paper  the 
terms  instincts,  emotions  and  sentiments  will  be  used  in  the 
light  of  the  above  definitions.  We  will  also  follow  his  classi- 
fication of  the  primary  emotions,  secondary  innate  tenden- 
cies and  sentiments. 

Consciousness  is  another  subject  concerning  which  there 
is  some  confusion.  In  the  mind  of  many  there  still  lurks  the 
metaphysical,  religious  notion  of  the  soul  or  something  ex- 
traneous which  acts  as  a sort  of  subjective  correlator  of  the 
psychical  functions.  Feeling  that  a clear  notion  of  con- 
sciousness is  extremely  essential  for  the  understanding  of 
insanity,  we  will  without  going  into  an  historical  or  critical 
discussion  of  the  subject  briefly  set  forth  and  analyze  our 
view. 

Consciousness  is  a growth;  it  is  the  result  of  the  up- 
buildings  of  the  various  elemental  functions  of  the  mind 
into  complex,  coordinated  manifestations.  It  is  not  a thing 
by  itself  added  onto  the  psychic  functions,  but  is  called  into 
being  by  the  completion  of  a psychical  process  which  can 
exist  for  itself.  Before  there  can  be  awareness  to  any  mental 
process  there  must  be  an  emotional  tone,  however  faint, 
added  to  it,  which  is  capable  of  bringing  it  to  a focus.  But 
the  possibility  of  the  mental  process  becoming  conscious  is 
inherent  in  the  very  process  itself.  The  construction  of  a 
building  furnishes  an  illustration.  To  build  a structure  are 
needed  bricks,  iron,  steel,  wood,  mortar,  tin,  glass,  stone, 
copper,  paint,  etc.  Taken  separately,  incoordinated,  they 
make  a mere  heap  of  different  substances,  but  as  the  steel, 
rocks,  bricks,  etc.,  are  put  together  we  see  as  if  by  a slow 
growth  the  building  taking  shape.  Finally  a complete 
structure  rises  out  of  the  heap.  Now,  there  is  nothing  in 
the  house  which  was  not  before  in  the  heap,  and  yet  we  have 


I.  S.  Wechsler , M.  D. 


379 


a complete  structure  in  the  one  and  confusion  in  the  other. 
So  with  consciousness.  The  various  ideas,  sensations,  per- 
ceptions, images,  memories,  etc.,  are  the  different  substances, 
which  can  only  become  conscious  when  they  are  built, 
organized  into  structures.  But  a plan  is  needed  to  evolve 
a building  out  of  its  component  parts;  even  so  is  it  with  the 
elemental  psychic  processes.  Herein,  however,  lies  the  one 
difference  between  the  two.  Where  in  the  inanimate 
structure  an  extraneous  force  is  needed  to  bring  arrange- 
ment out  of  chaos,  in  the  mind  the  inherent  tendency  to 
directed  growth  of  all  the  elements,  the  conative  tendency  of 
all  mental  processes,  the  innate  tendency  of  any  psychic 
manifestation  to  adopt  a feeling  tone,  all  combine  to  build 
a conscious  structure.  Not  only  that,  but  the  organic 
evolutionary  tendency  to  growth  from  the  simple  to  the 
complex,  which  is  transmitted  from  generation  to  generation, 
furnishes  practically  complete  the  ability  of  evolving  con- 
scious psychic  structures  out  of  the  elementary  psychic 
processes.  The  plan  is  inherent  in  the  protoplasm.  In  short 
consciousness  is  nothing  but  the  completed  structure  of  any 
psychical  process. 

Every  new  impression  or  sensation  or  idea  has  an  in- 
herent tendency  to  attach  itself  to  a previous  sensation,  etc., 
to  complete  a system,  or  to  form  a nucleus  around  which 
other  impressions  will  cluster.6  All  these  clusters  are  usually 
coordinated  and  form  in  time  a complete  psychical  make- 
up. But  there  is  ever  going  on  a struggle  for  survival  be- 
tween the  various  clusters.  An  emotional  tone  usually 
determines  whether  and  how  long  a cluster  shall  live.  A 
disturbance  in  the  emotional  tones  or  intensification  of  the 
one  at  the  expense  of  the  other  may  disrupt  the  harmony 
which  normally  exists  between  the  clusters  and  cause  various 
psychical  abnormalities.  So  also  ideas,  images,  sensations, 
perceptions,  memories,  etc.,  struggle  for  an  existence  in  the 
psyche.  They  would  be  lost  were  it  not  for  the  feeling  tone 
which  attaches  to  them.  The  chance  of  their  survival  is  in 
direct  proportion  to  the  intensity  of  the  feeling  tone,  those 
of  a painful  tone  usually  having  a greater  chance  to  survive. 
In  the  struggle  for  their  existence  chaos  often  results.  The 

cMorton  Prince,  The  Unconscious:  etc. 


380  Role  of  the  Emotions  in  the  Genesis  of  Insanities 

success  of  the  emotions  whose  individual  existence  is  con- 
trary to  the  welfare  of  the  individual  or  inharmonious  with 
his  character  results  in  a disturbance  of  his  psychical  system. 

. Rhythm  is  considered  as  a basic  universal  trait.  It 
characterizes  all  organic  and  inorganic  structures,  all  ani- 
mate and  inanimate  objects.  Rhythm  explains  the  phylo- 
genetic development  of  many  obscure  phenomena.  The 
beating  of  the  heart,  the  presence  of  a vagotonic  and  sym- 
pathicotonic system  in  the  body,  inhibition  and  stimulation, 
all  can  be  traced  to  the  primary  influence  of  rhythm.  Every- 
where this  balance  is  to  be  observed.  In  the  workings  of  the 
mind,  too,  one  can  observe  this  oscillation,  this  balance,  this 
rhythm.  All  our  instincts  and  our  accompanying  emotions, 
all  the  sentiments  are  thus  formed,  and  exist  in  such  a way 
as  to  balance  one  another.  Without  this  balance  there 
could  be  no  stable  psychical  existence.  Every  emotion  has 
its  opposing  emotion,  every  sentiment  its  opposing  senti- 
ment. Disturb  this  balance  and  you  disturb  the  psychical 
process.  In  common  parlance  the  mind  becomes  “lop- 
sided.” “The  Me,”  according  to  Ribot'  “is  rrfade  up  of 
opposite  , tendencies  . . . (which)  . . . tend  to 
equilibrate  one  another.  ” 

Generally,  ideas  either  reinforce  or  antagonize  one 
another;  the  same  is  true  of  emotions,  sentiments,  percepts, 
concepts,  judgments,  etc.  When  there  is  suppression  of  one 
side  or  want  of  balance  between  the  opposing  emotions,  etc., 
there  can  be  neither  antagonism  nor  reinforcement,  so  that 
there  is  manifested  the  absence  of  one  psychical  process  or 
the  exaggeration  of  another.  A pathological  process  is  the 
result.  And  just  as  our  so-called  faculties,  grouping  of 
emotions,  sentiments,  etc.,  do  not  develop  evenly  in  the  nor- 
mal person  so  in  the  pathological  processes  they  do  not 
deteriorate  or  are  thrown  out  of  balance  in  an  even  way. 
This  explains  the  grouping  of  symptoms,  their  manifestation, 
and  points  to  an  explanation  of  their  causation;  that  is,  the 
inherent  weakness  of  some  causes  them  to  be  easier  thrown 
out  of  balance. 

All  mental  symptoms  in  psychopathic  states  can  be 
shown  to  be  the  protrusion  into  consciousness  of  unbalanced 

7Th.  Ribot,  Diseases  of  Personality.  Humbold  Library  Series. 


381 


/.  S.  Wechsler , M.  D. 

primary  emotions  or  sentiments.  The  cleavage  in  the  case 
of  insanities  is  always  along  the  lines  of  the  primary  emo- 
tions. Insanity,  therefore,  is  a reversal  to  unbalanced 
primary  instincts  and  their  emotions  and  sentiments  and 
shows  the  want  of  balance  or  coordination.  The  primitive 
emotions  seek  expression  (and  get  it  objectively)  by  means  of 
their  conative  tendency,  only  there  are  no  opposing  emotions 
to  balance  them.  Thus,  the  delusion  of  sin  and  self-accusa- 
tion in  melancholia  brings  out  the  instinct  of  self-abasement 
and  the  negative  emotion  of  subjection  without  at  the  same 
time  bringing  to  the  surface  the  opposite  instinct  of  self- 
assertion  and  the  positive  emotion  of  elation.  The  reverse 
holds  true  in  the  case  of  the  delusion  of  grandeur.  The 
delusion  of  persecution  may  bring  out  the  emotion  of  fear, 
without  its  opposing  emotion  of  anger,  and  result  in  cowering, 
or  bring  out  anger  combined  with  self-assertion,  unopposed 
by  fear  and  subjection  and  result  in  positive,  active  persecu- 
tory delusions  of  the  paranoiac. 

All  instincts  and  their  accompanying  emotions  may 
come  into  play  at  one  time  or  another.  Sexual  jealousy 
which  consists  of  the  instinct  of  reproduction  plus  pugnacity 
may  be  allowed  to  go  rampant.  Depression  and  exaltation 
show  the  obtrusion  of  the  emotions  of  subjection  and  elation 
unopposed  by  the  instincts  of  self-assertion  and  self-abase- 
ment. Furor  brings  out  the  instinct  of  pugnacity  and 
the  emotion  of  anger  without  its  balancing  instinct  of  flight 
and  emotion  of  fear.  The  instinct  of  curiosity  and  emotion 
of  wonder  may  be  unopposed  by  the  instinct  of  flight  and 
emotion  of  fear;  so  may  the  unequilibrated  instinct  of  re- 
pulsion and  the  emotion  of  disgust  dominate  the  field.  The 
phobias  are  instances  of  an  opposite  state  of  affairs.  The 
production  of  pathological  symptoms  in  hysteria  through 
sympathy,  or  the  identification  with  others,  is  rooted  in  the 
primary  instinct  of  imitation  which  is  unbalanced  by  the 
instinct  of  self-assertion.  One  or  more  emotions  may  be 
systematized  and  formed  into  a complex,  which  is  indeed  the 
case  with  many  delusions.  In  all  delusions  it  will  be  noticed 
the  self  is  the  dominant  factor,  and  everything  exists  in 
relatiori  to  it. 

When  the  hysteric  suddenly  veers  from  laughter  to 
weeping,  from  modesty  to  brazenness,  from  love  to  hatred, 


382  Role  of  the  Emotions  in  the  Genesis  of  Insanities 

from  enthusiasm  to  apathy,  from  -shyness  to  rage,  we  see 
the  sudden  loss  of  balance  between  the  primary  emotions 
and  the  sharp  transfer  of  affective  states  from  one  extrzme 
to  another.  While  in  normal  conditions  this  shifting  of 
balance  needs  weighty  affective  reasons,  in  persons  in  whom 
there  is  an  extremely  precarious  balance  of  emotions  it  may 
occur  upon  very  slight  provocation.  Indeed,  what  seems  a 
reaction  altogether  out  of  proportion  to  the  stimulus  is  in 
those  with  weak  balance  an  accurate  representation  of  the 
acutely  oscillatory  state  in  which  their  emotions  perpetually 
exist. 

Disruption  or  disturbance  of  balance  may  take  place  in 
the  higher  psychical  processes,  provided  the  cleavage  is  along 
emotional  strata.  “The  inherent  affective  states  of  the 
individual,”  says  Ribot,8  “determine  the  choice  which  the 
will  is  to  make.”  Even  dissociation  of  personality  takes 
place  between  clusters  that  center  around  the  emotions  and 
sentiments.  But  as  our  emotions  are  better  organized  than 
our  higher  psychic  processes,  in  order  that  a real  disturbance 
of  personality  occur  it  must  be  in  the  sphere  of  the  emotions. 
Where  the  disruption  takes  place  in  the  higher  centers  alone, 
we  have  no  insanity  as  yet.  A dissociation  in  speech,  a 
motor  or  sensory  aphasia,  or  an  amnesia  is  not  yet  an  in- 
sanity.9 It  is  simply  a disturbance  of  symbols.  But  where 
tie  disturbance  affects  the  emotions  centering  around  speech 
or  hearing  or  sight  then  we  have  hallucinations  and  delu- 
sions, and  insanity.  It  has  been  said  above  that  conscious- 
ness is  the  completed  structure  of  any  psychical  process, 
and  that  insanity  is  a disturbance  in  the  normal  balance  of 
the  emotions  which  go  to  make  up  psychical  processes. 
It  follows,  therefore,  that  in  insanities  there  is  not  only  a 
disturbance  in  the  emotions  but  in  the  conscious  states 
formed  of  and  around  them.  This  disturbance  in  con- 
sciousness need  not  however  be  complete  in  order  to  result  in 
an  insane  state.  Little  bits  of  consciousness  may  be  dis- 
rupted and  little  bits  of  insanities  result.  And  to  go  back 
to  our  homely  analogy  of  a building,  only  a window  here,  a 
door  there,  or  a wall  in  another  place  may  be  knocked  out; 

sTh.  Ribot,  Diseases  of  the  \\  ill. 

9Th.  Ribot,  Diseases  of  Memory. 


I.  S.  JVechsler , M.  D. 


3^3 


so  in  insanities  an  emotion  here,  a sentiment  there,  a memory 
grouped  around  an  emotion  in  another,  place  may  be  des- 
troyed or  unbalanced,  and  we  have  an  explanation  for  the 
queer  manifestation  or  grouping  of  symptoms.  It  happens 
too  that  repairs  take  place  or  that  the  building  is  slowly 
undermined  or  is  altogether  gutted  and  then  we  have  re- 
covery or  slow  deterioration  or  complete  dementia.  In 
imbecility  there  is  lack  of  development  or  abolition  of  the 
different  elementary  brain  functions  preventing  the  forma- 
tion of  higher  psychic  processes  and  their  attendant  con- 
scious states.  Occasionally,  besides  the  weakening,  there 
is  also  a disturbance  of  the  equilibrium  of  the  rudimentary  or 
residual  psychic  processes  and  the  result  is  flickering  or 
sparkling  of  primary  emotions. 

Without  having  analyzed  every  symptom  which  may 
arise  in  the  insanities,  enough  has  been  said  to  show  that  it 
could  be  done  along  the  lines  of  the  emotions  and  sentiments 
and  their  various  groupings.  But  while  it  may  be  conceded 
that  the  analysis  holds  true  for  the  affective  psychoses  and 
the  psychoneuroses  exception  may  be  taken  to  the  ex- 
planation when  it  comes  to  the  organic  psychoses.  There  is 
however  sufficient  ground  for  believing  that  even  those 
psychoses  which  cannot  be  explained  anatomically  have  an 
organic  basis  behind  them.  Further,  many  psychologists 
postulate  a physical  process  behind  every  psychical  one. 
Memory  has  been  defined  as  “the  establishment  of  certain 
modifications  of  nerve  elements  and  dynamic  associations 
etc.”10  Recent  work  on  the  emotions11  has  shown  the  re- 
ciprocal effect  of  psychic  processes  on  the  organic  bodily 
functions,  particularly  with  reference  to  the  internal  se- 
cretions, and  vice  versa.  Crile  has  also  shown  that  actual 
anatomico-pathological  conditions  result  in  the  brain,  follow- 
ing severe  emotional  shock.  It  has  been  noted  also  that 
even  in  organic  psychoses  there  is  disintegration  along  the 
lines  of  emotion  and  sentiment  as  developed  by  heredity, 
environment  and  education.12  An  explanation  has  been 
offered  of  hallucination  as  a “dissociation  of  the  peripheral 
(physical,  psychic  or  somatic)  sensations  from  the  sensory- 

10Th.  Ribot,  Diseases  of  Memory. 

1 1Crile  and  Cannon. 

12Tanzi,  Text  Book  of  Mental  Diseases. 


3 84  Role  of  the  Emotions  in  the  Genesis  of  Insanities 

motor  or  ideo-motor  content13”  and  that  this  dissociation 
also  involves  the  emotions.  Finally,  we  may  leave  to  the 
physiology  and  pathology  the  explanation  which  psychology 
hopes  to  but  cannot  offer. 

Thus  far  we  have  tried  to  show  that  there  is  no  insanity 
but  states  of  insanity,  that  insanities  differ  from  normal 
psychical  processes  only  in  degree  and  not  in  form,  and  that 
the  symptoms  are  directly  traceable  to  disturbances  in  the 
normal  balance  of  the  emotions,  etc.,  and  their  accompany- 
ing conscious  states.  In  the  second  half  of  this  paper  it  will 
be  shown  how  the  normal  primary  states  (with  one  great  ex- 
ception) serve  for  the  preservation  of  the  individual  and  that 
disturbance  in  the  emotions  involves  a further  disturbance 
of  relation,  that  of  individual  to  the  species.  Viewed  in  this 
light  any  severe  disturbance  to  the  primary  innate  psycho- 
physical tendencies  and  their  affective  tones  assumes  great 
importance  and  is  fraught  with  danger  not  only  to  the  in- 
dividual but  also  to  the  species. 

The  Evolutionary  Struggle  and  Insanities 

Among  all  gregarious  animals  a constant  struggle  may 
be  observed  to  be  going  on  between  the  individual  and  the 
species.  The  individual  is  intensely  interested  in  his  own 
welfare;  the  species  is  interested  in  him  only  in  so  far  as  he 
furthers  its  purposes.  Once  that  aim  is  accomplished,  the 
species  loses  all  interest  in  him  and  becomes  indifferent  to 
his  existence.  Indeed  there  are  instances  where,  as  soon  as 
the  individual  has  accomplished  his  purpose  of  propagating 
the  race,  he  is  actually  destroyed.14  Where  higher  psychic 
life  is  developed  there  arises  inevitable  conflict  out  of  these 
two  opposing  tendencies.  In  this  conflict  it  has  been  ob- 
served that  the  individual  is  usually  the  vanquished  and  the 
species  the  victor.  The  former  is  ever  impotent  before  the 
overpowering  current  of  the  latter. 

A few  of  the  lower  and  many  of  the  higher  animals 
bestow  tender  care  on  their  young  until  they  are  able  to 
reproduce  their  kind.  The  whole  social  organism  seems  to 

1 3 Sidis, Symptomatology, Psychogaosls  and  Diagnosis  of  Psychopathic  Diseases. 

14Maurice  Maeterlinck  has  beautifully  described  this  in  The  Life  of  the  Bee. 


I.  S.  Wechsler , M.  D. 


385 


be  interested  in  the  bringing  forth  and  the  rearing  of  its 
young.  The  ceremonies  attendant  upon  the  mundane  de- 
but of  the  human  animal  furnish  a social  instance  of  biologic 
significance.  The  one  that  undertakes  a conflict  starts  out 
upon  an  unequal  struggle  which  must  ultimately  end  in  his 
defeat  or  submergence.  There  are  instances,  it  is  true, 
where  the  individual  gains  the  upper  hand  and  even  puts 
his  stamp  on  the  organism  of  which  he  is  a part,  but  in  the 
end  it  is  always  the  same:  he  does  nothing  but  serve  the 
purpose  of  the  species.  Those  types  of  reactions  in  an  in- 
dividual which  best  serve  the  welfare  of  the  species  have  the 
greatest  chance  to  survive.  “The  process  going  on  in  the 
satisfactorily  developed  gregarious,  animal  is  the  moulding 
of  the  varied  reactions  of  the  individual  into  functions 
beneficial  to  him  only  indirectly  through  the  welfare  of  the 
new  unit — the  herd.  ”lu 

This  struggle,  which  in  lower  species  results  in  the  com- 
plete submergence  of  the  individual,  in  the  human  species 
often  -results  in  temporary  submergence:  insanities.  That 
conflict  is  a cause  of  insanity  has  been  amply  recognized  by 
abnormal  psychology;  what  has  not  been  so  clearly  re- 
cognized is  that  this  conflict  has  its  roots  in  biologic  exis- 
tence, in  the  evolutionary  struggle  for  the  preservation  of 
the  species.  In  the  human  mind  this  conflict  takes  place 
in  the  various  psychic  spheres,  and  in  order  to  lead  to  dis- 
ruption ultimately  involves  the  lowest,  primary,  best  or- 
ganized psychic  elements — the  instincts  and  their  emotions. 

Nutrition  and  all  that  goes  with  it  (growth,  etc.,)  mainly 
subserve  the  preservation  of  the  individual,  reproduction 
that  of  the  preservation  of  the  species.  In  gregarious 
animals,  more  particularly  man,  most  of  the  primary  in- 
stincts and  emotions  serve  directly  the  welfare  of  the 
individual,  while  the  higher  psychical  processes,  the  senti- 
ments with  moral,  ethical  values  bear  the  stamp  of  the  re- 
lation of  the  individual  to  the  social  organism,  and  mainly 
serve  the  existence  and  perpetuation  of  the  species.  The 
higher  psychic  processes  are  more  elastic  and  permit  of 
greater  adaptation,  of  interaction  between  individual  and 
individual  and  promote  the  welfare  of  the  group.  But  the 

1 5Trotter,  The  Herd  Instinct.  Two  essays  in  the  Sociological  Review,  1903 
and  1909. 


386  Role  of  the  Emotions  in  the  Genesis  of  Insanities 

lower,  primary  emotions  are  more  highly  organized;  the}' 
are  more  intense,  more  centered  around  the  ego,  the  unit  of 
the  species.  Conflict  must  of  necessity  result  between  the 
instincts  for  the  preservation  of  the  individual  and  those 
for  the  preservation  of  the  race.  In  the  conflicts  of  an  in- 
dividual we  often  see  the  ruin  of  the  contending  forces, 
with  the  greater  destruction  of  the  higher,  but  weaker,  less 
organized  psychic  elements.  There  is  utter  confusion  in  the 
disorganized  ranks  and  each  combatant  wanders  aimlessly. 
Owing  to  the  loss  of  effective  balance  each  separate  emotion 
tries  to  fight  its  own  battle,  attracts  certain  forces  to  itself, 
but  in  the  end  remains  an  aimless  straggler  going  to  its  own 
destruction.  And  finally*  this  want  of  equilibration  between 
the  emotions  undermines  all  higher  psychic  processes. 

The  inherent  instability  in  one’s  emotions  predispose 
him  to  conflict  and  when  an  individual  has  undertaken  the 
struggle  and  been  unequal  to  the  task  he  suffers  disarrange- 
ment in  the  balance  of  his  emotions;  which  means  defeat. 
And  this  is  what  actually  happens  in  insanity.  But  not 
only  is  elimination  from  the  contest  the  ultimate  result  of 
dementia,  but  the  destructive  and  self-destructive  tendency 
of  the  insane  is  the  direct  result  of  the  inevitable  tendency  to 
destruction  of  any  emotion  which  is  not  balanced  by  its 
opposing  emotion.  Each  emotion  trying  to  preserve  its 
own  existence  loses  touch  with  the  other  emotions  and  under- 
mines the  individual  in  his  relation  with  the  group.  In- 
sanity., therefore,  is  nature's  way  of  trying  to  kill  of  the 
gregariously  unfit.  “Whom  the  gods  want  to  destroy  they 
first  make  mad.  ” 

Before  proceeding  further  with  this  exposition  it  may 
be  necessary  for  the  sake  of  clearness  to  point  out  two  things. 
First,  the  term  evolution  is  used  in  the  broad  (or  limited?) 
natural  philosophical  sense  of  the  survival  of  the  fittest  and 
does  not  include  variation,  etc.,  and  second,  that  the  reference 
to  lower  animals  is  made  only  by  way  of  analogy,  to  show 
the  biological  significance  of  conflict.  When  we  speak  of 
psychic  conflict,  we  realize,  of  course,  the  meager  evidence 
there  is  for  supposing  its  existence  in  lower  gregarious 
animals.  But  the  varied  reactions  between  the  individual 
and  the  group,  which  are  observed,  lead  to  the  belief  that  in 
the  highest  gregarious  animal — man — the  conscious  or  un- 


1.  S.  Wechsler , M.  D. 


387 


conscious  struggle  for  existence  bears  close  biologic  resem- 
blance. If  that  is  conceded,  then  we  may  speak  of  the 
social  body  in  terms  of  species  and  of  the  conflict  in  terms  of 
evolution.  Then  we  may  speak  of  the  sentiments  and  other 
higher  psychic  processes  which  are  peculiar  to  man  as 
evolutionary  steps,  and  of  insanities  as  a high  evolutionary 
process. 

Sympathy,  while  not  a primary  emotion,  is  an  inherent 
tendency  in  an  individual  which  bears  particular  relation 
to  the  welfare  of  the  species.  The  feeling  and  tendency  to 
act  when  others  are  in  need  or  danger  is  not  due  to  cold 
calculation  as  to  the  possible  benefits  to  the  individual  re- 
motely likely  to  accrue  from  the  act.  It  really  promotes 
the  welfare  of  the  species;  and  it  is  noteworthy  that  in  the 
insane  true  sympathy  is  rarely  found  or  ever  intensified. 
Insanity  being  the  result  of  the  struggle  between  the  in- 
dividual and  the  group,  any  emotion  likely  to  promote  the 
welfare  of  the  latter  finds  no  room  in  one  struggling  for  the 
supremacy  of  the  self.  In  the  case  of  the  insane,  quite  the 
contrary,  only  those  emotions  which  speak  for  the  ego,  and 
if  unopposed  lead  to  the  destruction  of  others  or  blindly  to 
the  destruction  of  the  self,  only  such  emotions  find  powerful 
expression.  Everybody,  everything  is  against  the  ego, 
therefore  they  must  be  destroyed.  That  this  destructive 
tendency  often  reacts  on  the  individual  is  either  incidental 
or  the  inevitable  result  to  escape  the  conflict;  but  the  aim 
in  the  latter  case  is  to  strengthen  the  individual,  only  the 
result  of  the  blind  attempt  is  destruction. 

The  reason  why  sex  plays  such  an  important  part  in 
insanities  and,  according  to  psychanalysts,  the  main  one  in 
psychoneuroses,  is  that  on  the  field  of  reproduction  is  the 
struggle  between  the  individual  and  the  species  acutest. 
As  the  sexual  instinct  is  primarily  for  the  preservation  of 
the  race,  it  is  also  the  point  of  cleavage  between  the  in- 
dividual and  the  species.  Instinctively  the  individual  feels 
that  his  existence  is  endangered  by  the  possibility  of  his 
being  replaced.  The  result  of  the  conflict  on  the  field  of 
reproduction  is  shown  not  only  by  the  frequency  of  the 
neuroses  but  also  of  the  psychoses  which  take  place  at 
puberty,  pregnancy,  parturition,  lactation,  involution.  The 
conflict  however  is  not  only  one  centered  around  custom, 


388  Role  of  the  Emotions  in  the  Genesis  of  Insanities 

habit,  environment,  education,  social  morality,  etc.,  but  one 
which  is  deeply  rooted  in  the  individual  and  the  species. 

During  the  conflict  the  individual  often  loses  touch  with 
the  group  to  which  he  belongs.  In  many  cases  of  insanity, 
particularly  dementia  praecox,  there  is  a loss  of  adaptation 
to  reality  with  the  consequent  construction  of  subjective, 
phantasmagoric  structures.  Now  the  emotions  remain 
purely  subjective,  unless  they  find  balanced  expression  in 
objectivism  (reality).  In  the  normal  individual  the  emo- 
tion always,  find  objective  expression.  As  soon  as  the 
struggle  with  the  environment  is  too  great  for  the  individual 
he  gives  up  the  attempt  and  the  result  is  either  disintegra- 
tion or  the  reconstruction  of  the  subjective  world  without 
reference  to  objective  reality.  In  this  reconstruction  the 
individual  emotions  are  often  obtruded  into  consciousness 
so  unequilibrated  as  to  result  in  states  of  the  individual 
which  are  in  perpetual  conflict  with  his  social  organism. 

This  anti-social  characteristic  of  lunacy  has  long  ago 
been  remarked.  Take  away  this  characteristic  and  the 
most  accepted  criterion  of  insanity  disappears.16  This  is 
also  evident  in  the  varied  conceptions  which  are  prevalent 
in  societies  at  different  stages  of  development,  and  the 
changes  which  are  brought  about  in  the  ascent.  In  old 
societies  custom  is  extremely  rigid  and  the  individual  is 
practically  enslaved  to  the  group.  Nevertheless  insanities 
are  by  far  less  common  than  in  civilized  communities.  We 
may  venture  two  main  explanations:  First,  the  rigid  group 
influence  to  which  the  individual  is  subjected  almost  from 
birth  is  so  strong  that  it  permits  of  the  development  in  him 
of  little  that  is  not  in  accord  with  the  group,  and  second, 
the  individual  is  in  no  position  to  undertake  a conflict.  To 
do  so  means  death — no  compromise.  Whereas,  in  order 
that  insanity  may  develop,  it  is  necessary  that  the  social 
group  be  sufficiently  organized  to  resist  assault  by  the  in- 
dividual and  yet  sufficiently  lax  to  permit  or  even  invite  it. 

In  the  similarity  which  has  been  discovered  between  the 
criminal,  the  genius  and  the  insane  one  fundamental  differ- 
ence seems  to  have  been  overlooked.  This  difference  lies 
not  so  much  in  the  method  of  conflict  which  has  been  ob- 

lr' Bernard  Hart,  The  Psychology  of  Insanity,  and  A Philosophy  of  Insanity; 
Journal  of  Mental  Sciences,  July  1908. 


I.  S.  Wechsler , M.  D. 


389 


served  to  be  common  to  all,  but  in  the  result.  In  each  case 
the  individual  stands  up  against  the  social  organism,  but 
where  insanity  is  a defensive  reaction  wherein  the  individual 
is  destroyed,  criminality  and  genius  are  offensive  reactions. 
VVe  will  not  enter  into  subjects  of  criminality  which  is  so 
intimately  connected  with  our  economic  system  and  which 
many  sociologists  hold  to  be  wholly  responsible  for  it. 
Besides,  the  tendency  of  looking  at  the  insane  as  criminal 
has  been  reversed  to  that  of  looking  upon  the  criminal  as 
insane.  Between  genius  and  insanity,  however,  there  is  a 
complete  similarity  with  one  very  fundamental  distinction. 

Both  the  insane  and  the  genius  are  the  result  of  the 
struggle  of  the  individual  with  the  group,  but  whereas  the 
former  is  the  individual  vanquished  in  the  struggle  with  the 
species,  genius  is  the  individual  triumphant  in  the  struggle 
with  the  species.  The  genius  who  has  been  triumphant  for  a 
time  often  loses  out  'by  becoming  insane,  and  he  is  further 
eliminated  in  that  he  is  rarely  perpetuated  in  the  offspring. 
Having  once  been  beaten  the  species  absorbs  the  powers  of 
the  individual  and  disseminates  them  among  its  components. 
Evolution  while  it  is  an  ascending  process  is  at  the  same  time 
a levelling  one. 

In  conclusion  we  wish  to  point  out  that  insanity  is  the 
tribute  society  is  compelled  to  pay  to  the  individual  for  having 
levied  on  his  ego  for  the  formation  of  a social  organism.  The 
individual  w’ho  persists  in  giving  battle  but  is  unequal  to 
the  task  must  eventually  succumb.  And  while  it  is  right 
that  the  species  should  and  does  win  over  the  individual, 
the  fact  must  not  be  lost  sight  of  that  there  is  a struggle. 
The  present  day  tendency  to  force  the  individual  to  lose 
himself  completely  in  the  social  group  is  fraught  with  great 
dangers.  The  conflict  aroused  in  the  conscious  and  un- 
conscious psychical  processes  is  apt  to  tear  out  some  of  the  . 
primary  emotions  root  and  branch  and  lead  to  various 
psychical  abnormalities.  The  human  mind  must  be  given 
sufficient  individual  latitude  and  not  be  altogether  sub- 
merged in  the  group.  The  natural  tendency  toward  elimina- 
tion of  the  individuals  who  are  unfit  to  adapt  themselves  in 
the  struggle  with  the  species  is  sufficient  for  the  purpose.  It 
is  not  necessary  to  accelerate  or  intensify  the  process  by 
artificial  levies  on  individuality. 


SOME  CURRENT  MISCONCEPTIONS  OF 
PSYCHOANALYSIS 


BY  S.  A.  TANNENBAUM,  M.  D. 

New  York 

SUCH  criticism  of  the  Freudian  psychology  as  that 
advanced  by  Professor  Woodworth  in  the  August, 
1917,  issue  of  The  Journal  of  Abnormal  Psychology 
deserves  more  serious  consideration  than  that  ac- 
corded to  the  majority  of  criticisms  directed  against  psycho- 
analysis. Professor  Woodworth,  by  virtue  of  his  eminence 
and  position,  may  be  assumed  to  know  whereof  he  speaks 
and  to  have  given  scientific  consideration  to  his  thoughts  on 
the  subject  before  sending  them  out  to  enlighten  the  multi- 
tude and  confound  the  scribes.  It  will  therefore  not  do  to 
dismiss  his  paper  with  a contemptuous  wave  of  the  hand 
or  an  indifferent  shrug  of  the  shoulders.  If  his  facts  are 
facts  and  if,  as  such,  they  conflict  with  the  psychoanalytic 
theory,  if  his  arguments  are  sound  and  his  criticisms  just, 
the  Freudian  psychology  must  be  materially  modified  or 
altogether  relegated  to  the  dust-heap  of  error.  In  the  fol- 
lowing consideration  of  Professor  Woodworth’s  remarks  no 
attempt  at  a systematic  contribution  to  the  subject  will  be 
undertaken,  and  only  such  of  his  criticisms  will  be  subjected 
to  comment  as  seem  material  to  the  issues  involved. 

To  begin  with,  Professor  Woodworth  expressly  protests 
his  right  to  present  evidence  in  the  case  no  matter  what  his 
complexes  may  be,  and  no  matter  how  much  he  may  be 
biassed  against  psychoanalysts  for  what  he  calls  their  shabby 
treatment  of  psychologists  and  their  contempt  for  current 
psychology.  Now,  as  to  the  Professor’s  right  to  present 
evidence  there  can,  of  course,  be  no  question.  The  presenta- 
tion of  evidence  is  always  in  order.  But  a biassed  and  irri- 
tated critic,  such  as  Dr.  Woodworth  with  engaging  candor 
admits  himself  to  be,  will  rarely  be  able  to  present  unbiassed 
evidence;  his  bias  is  sure  to  interfere  with  a correct  under- 

390 


S.  A.  Tannenbaum , M.  D. 


39i 


standing  of  the  subject  matter  under  consideration.  All  the 
world  knows  that  bias  impairs  the  sight  and  distorts  the 
judgment.  That  this  truism  is  once  more  confirmed  by 
Dr.  Woodworth’s  criticism  we  hope  to  show  in  what  follows. 

Our  critic  first  devotes  his  attention  to  the  Freudians’ 
methods  of  discovering  facts  and  reaching  psychological 
conclusions, — methods  which  he  condemns  as  “excessively 
rough  and  ready.”  Whether  this  characterization  is  justi- 
fied by  the  facts,  and  whether  our  critic  is  not  really  con- 
demning what  he  does  not  sufficiently  know  or  understand 
will  be  our  first  concern. 

Speaking  of  the  Freudians’  methods,  he  says:  “ there 
seem  to  be  two  of  them,  fundamentally,  one  in  which  the  sub- 
ject himself  furnishes  the  analysis  under  the  guidance  of  the 
psychoanalyst,  and  the  other  in  which  the  psychoanalyst 
works  with  comparatively  little  contribution  from  the  sub- 
ject, by  the  aid  of  fixed  symbols  ....  [the  first-named 
method]  starts  from  an  element  of  a dream,  or  from  a lapse, 
or  from  a ‘complex-indicator’  in  the  free  association  test;  it 
proceeds  by  requiring  the  subject  to  let  his  mind  move 
freely  from  the  starting-point,  without  self-criticism  or  re- 
serve; and  it  terminates,  for  the  moment,  when  the  subject,  in 
the  course  of  this  free  movement  of  thought,  hits  upon  a complex. 
Now,  as  far  as  the  object  in  view  is  to  bring  the  complex  to  light, 
this  is  all  well  and  good  ....  But  the  psychoanalyst 
is  not  contented  with  simply  drawing  the  conclusion  that 
the  subject  has  the  discovered  complex.  He  goes  on  to  two 
other  assertions.  He  concludes,  first,  that  arriving  at  the 
complex  by  starting  with  the  dream  or  complex  indicator  means 
that  the  complex  was  at  the  bottom  of  the  dream  or  complex 
indicator.  ” The  italics  are  mine,  and  are  intended  to  call 
attention  to  the  critic’s  most  serious  errors. 

There  are  not  two  methods  of  conducting  a psycho- 
analytic investigation.  Freud  still  adheres  strictly  to  the 
method  of  free  associations  when  he  is  analysing  a subject’s 
dream,  lapse,  or  symptom.  Those  of  his  followers  who  are 
best  acquainted  with  his  theories  and  technique  find  that 
they,  too,  achieve  the  best  results  only  by  adhering  to  this 
method.  However,  before  considering  further  Professor 
Woodworth’s  assertion  that  psychoanalysts  do  make  use  of 


392  Some  Current  Misconceptions  of  Psychoanalysis 

a second  method — that  of  “fixed  symbols” — let  us  take  up 
his  criticism  of  their  application  of  the  first  method — that  of 
free  associations. 

Now,  I venture  to  say  that  few  more  grotesque  distor- 
tions of  the  truth  about  psychoanalysis  have  ever  been  pub- 
lished than  the  statement  that  the  free  associations  terminate 
“for  the  moment,  when  the  subject  hits  upon  a complex.” 
The  fundamental  truth  of  the  matter  is  that  the  associations 
do  not  terminate  when  a complex  has  been  discovered  but 
when  the  complex  or  complexes  responsible  for  the  lapse  or 
symptom  have  been  brought  to  light — when  the  subject  gets 
the  feeling  that  he  has  discovered  the  cause  for  the  manifes- 
tation under  consideration.  Before  he  finds  this  particular 
complex,  if  only  one  is  involved,  he  may  touch  upon  and 
discuss  many  other  complexes;  but  he  will  dismiss  these 
because  he  knows  that  they  are  not  of  such  a nature  as  to 
explain  his  lapse  or  symptom.  When  a detective  sets  out 
to  discover  the  person  guilty  of  a crime  he  does  not  terminate 
his  hunt  when  he  comes  upon  a “suspicious  character”  in 
the  street  or  even  a notorious  criminal.  He  stops  his  pur- 
suit only  when  he  has  discovered  the  individual  to  whom  all 
the  evidence  points  as  the  culprit.  Just  so  the  Freudian : 
for  all  our  critic’s  saying  so,  he  does  not  accuse  the  first 
complex  he  comes  upon  “more  or  less  directly.” 

In  the  analysis  of  a dream,  for  example,  the  subject 
gives  his  associations  to  the  different  dream  details.  Numer- 
ous complexes  are  touched  upon  or  brought  to  light  in  the 
course  of  such  associations;  but  the  meaning  of  the  dream, 
the  essential  motive  for  its  construction,  is  obtained  only 
after  a long  and  difficult  analysis  of  its  constituents  and 
upon  a subsequent  synthesis.  The  technique  thus  briefly 
indicated  bears  not  the  remotest  resemblance  to  that  describ- 
ed by  Dr.  Woodworth.  Tet  us  illustrate  this  by  the  follow- 
ing dream-analysis  published  by  Dr.  Staercke:  a Dutch 
physician  dreamt  that  on  the  last  joint  of  his  index  finger  he 
had  a primary  syphilitic  affection  (i.  e.,  a chancre).  The 
dreamer  had  never  had  syphilis,  and  would  never  wish 
himself  anything  so  terrible.  He  recalled  that  shortly 
before  this  dream  he  had  seen  a picture  of  such  a chancre  in 
an  atlas  on  diseases  of  the  skin;  and  then  he  remembered 


S.  A.  Tannenbaum,  AI.  D. 


393 


having  been  taught  that  the  word  “syphilis”  was  derived 
from  the  Greek  “sus”  (swine)  and  “philos”  (loving).  The 
word  “sus”  recalled  “Susi,”  the  name  of  a trained  hinny 
he  had  recently  seen  at  a circus;  the  name  “Susi”  reminded 
him,  in  turn,  of  the  circumstance  that,  to  his  great  regret, 
his  sisters-in-law  (“zusje”  in  Dutch)  were  becoming  too 
grown-up  to  sit  on  his  lap.  Furthermore,  “Suze”  was  the 
name  of  an  Indo-European  (mixed  breed — like  a hinny!) 
woman  whom  he  loved,  but  who  did  not  return  his  passion; 
whenever  he  angered  her  she  used  to  stamp  on  the  ground 
with  her  foot — an  action  that  reminded  him  of  one  of  Susi’s 
tricks  at  the  circus.  And  then,  too,  in  his  childhood  he 
had  long  harbored  a strong  desire  for  a sister  (“zuster,  ” 
“zusje”).  When  he  was  seven  or  eight  years  old  he 
used  to  play  with  a little  cousin  aged  five  and  he  had 
often  wished  that  she  were  his  sister;  but  after  a disagreeable 
experience  with  her  he  had  repressed  her  from  his  memory. 
In  this  dream,  then,  we  find  a symbol  (syphilis)  in  which 
several  wishes  are  condensed,  viz.:  his  sisters-in-law,  a sister, 
and  Suze.  Now,  in  Holland  it  is  customary  to  raise  an 
index  finger  when  one  takes  an  oath;  and  the  Dutch  word 
“zweeren”  meaning  to  “take  an  oath”  also  means  to  “have 
a swelling.”  The  lesion  being  on  the  tip  of  the  finger  indi- 
cates that  the  subject  goes  “to  extremes”  in  his  love, — he 
recalls  that  when  Suze  had  a coryza  he  had  wished  that  she 
would  infect  him,  and  that  he  had  at  various  times  said  that 
if  he  loved  a woman  he  would  not  be  deterred  in  his  wooing 
even  by  the  possibility  of  being  infected  with  syphilis.  Thus 
the  intensity  of  his  love  is  measured  by  the  gravity  of  the 
infection  (not  merely  a coryza)  as  well  as  by  the  location  of 
the  lesion.  “Primary  affection”  (the  literal  Dutch  equiva- 
lent of  our  “primary  lesion”)  may  be  translated  “first  love.  ” 
We  may  say,  then,  from  a synthesis  of  all  these  associations, 
that  the  dream  means:  “I  have  Suze’s  love  and  I love  her 
to  the  tips  of  my  fingers,”  or  “Even  at  the  risk  of  syphilis 
I wish  I had  Suze’s  love!”  The  picture  in  the  atlas  on 
cutaneous  diseases  served  as  the  dream-inciter  and  served 
to  stir  several  complexes  into  activity.  Had  the  analyst 
in  this  case  merely  followed  the  method  outlined  by  Dr. 
Woodworth  and  stopped  when  he  hit  upon  a complex,  or 


394  Some  Current  Misconceptions  of  Psychoanalysis 

had  he  applied  the  “method  of  fixed  symbols”  (finger  = 
phallus,  syphilis  = crime,  sin,  incest,  etc.),  he  could  not  have 
interpreted  the  dream. 

It  is  not  true,  then,  that  Freud  teaches  that  arriving  at 
a complex  means  that  that  complex  was  at  the  bottom  of  the 
dream  or  complex  indicator.  It  is  not  true  that  Freud 
teaches  that  “if  the  subject  has  stumbled  over  a certain 
word  in  the  free  association  test,  and  then,  letting  his  mind 
move  freely  from  this  word  as  a starting-point,  has  come 
more  or  less  directly  upon  a certain  complex,  then  the  stirring 
of  that  complex  was  the  cause  of  the  stumbling  in  the  original 
test.”  Nor  is  it  according  to  Freud  to  say  that  “if  the 
subject  has  dreamed  of  a person  A,  and  on  letting  his  mind 
move  freely  from  the  thought  of  A comes  more  or  less  directly 
to  think  of  a significant  person  B,  then  A in  the  dream  is 
really  a representation  of  B.  ” What  our  critic  fails  to  note 
is  that  in  such  a case  there  are  definite  connecting  links  or 
identifying  features  between  A and  B,  that  they  resemble 
each  other  in  certain  unmistakable  respects,  whether  in 
name,  size,  color,  peculiar  feature,  characteristic  mannerism, 
or  what-not.  Thus,  in  the  above  dream,  “syphilis”  stands 
for  Suze  both  because  the  syllable  “sus”  occurs  in  both 
words  and  because  thoughts  of  syphilis  bore  a definite  rela- 
tionship to  Suze. 

There  is  then  no  justification  for  Professor  Woodworth’s 
remark  that  ilby  such  reasoning  the  conclusions  are  reached 
that  dreams  have  a hidden  meaning  very  different  from 
their  manifest  content,  and  that  lapses  and  hesitations  in 
the  process  of  thinking  or  acting  are  due  to  the  stirring  of 
submerged  complexes.”  If  Freud’s  reasoning  had  been  no 
keener  than  that  attributed  to  him  by  our  critic  he  could 
never  have  brought  so  many  fine  psychologists  and  Men- 
schenkenner  the  world  over  to  his  way  of  thinking!  But  let 
us  look  into  this  particular  objection  a little  further. 

“Can  the  psychoanalyst,  ” asks  our  critic,  “seriously 
maintain  that,  whenever  the  thought  of  A has  come  into  my 
mind , if  I then  let  my  mind  move  freely  from  A and  reach 
B (sooner  or  later),  B must  have  been  operative  in  making 
me  think  of  A in  the  first  place?”  Of  course,  no  psycho- 
analyst maintains  or  believes  anything  so  absurd  either 


S.  A.  Tannenbaum,  M.  D. 


395 


directly  or  by  implication.  What  he  does  maintain  is  that 
if  a thought  (A)  “ spontaneously ” comes  into  his  mind,  or 
comes  in  place  of  another  that  was  sought,  and  he  wishes 
to  discover  the  cause  for  the  spontaneous  mental  presenta- 
tion or  lapse,  he  has  only  to  let  his  thoughts  play  around  it 
freely,  taking  all  the  attending  circumstances  into  considera- 
tion and  not  permitting  anything  to  shunt  his  thoughts  into 
other  (unrelated)  channels,  to  discover  certain  thoughts  and 
emotions  (B)  which  will  give  him  the  feeling  that  they  were 
responsible  for  the  phenomenon  A.  If  a detective  leaves 
the  scene  of  a crime  and  roams  aimlessly  about  the  streets 
and  sooner  or  later  wantonly  pounces  upon  a citizen  who 
happens  to  cross  his  path,  he  will  almost  inevitably  make  a 
mistake;  but,  if  he  leaves  the  scene  with  certain  clues  in  his 
possession,  and  follows  these  clues  to  their  logical  destina- 
tion, no  matter  whither  they  may  lead,  he  will  invariably, 
sooner  or  later,  succeed  in  his  quest.  The  purpose  of  this 
analogy  is  to  emphasize  the  following  facts,  which  our  critic 
seems  to  have  wholly  overlooked:  the  psychoanalytic  investi- 
gation is  not  a rambling,  purposeless  excursion  into  the 
psychic  domain  with  no  other  object  than  that  of  discover- 
ing complexes,  but  a definite  and  purposeful  quest  for  a 
particular  complex  that  has  brought  about  an  imperfection 
in  psychic  functioning.  The  course  of  the  free  associations 
is  determined  by  the  object  in  view.  The  subject  has  a 
definite  problem  in  mind  when  he  sets  forth  on  his  errand. 
The  lapse  is  the  starting  point  upon  which  the  subject  con- 
centrates his  attention  as  he  sets  out;  and  this  introspective 
concentration,  because  of  the  purpose  in  the  background, 
determines  the  course  his  associations  will  take — just  as  our 
imaginary  detective  sets  out  with  his  clues  (which  correspond 
to  the  circumstances  under  which  the  lapse  occurred  and  to 
the  nature  of  the  lapse)  and  follows  these,  overcoming  all 
the  obstacles  in  his  path  (the  resistances)  until  he  has  dis- 
covered the  person  (the  complex)  to  whom  the  clues  point 
and  who  has  the  motive  adequate  for  the  commission  of  the 
crime  (lapse)  in  question.  This,  I submit,  is  a very  different 
procedure  from  that  described  by  our  critic  in  his  burlesque 
or  caricature  of  psychoanalysis. 


396  Some  Current  Misconceptions  of  Psychoanalysis 

We  are  next  asked  by  Dr.  Woodworth:  “And  how  does 
[the  psychoanalyst]  know  when  to  stop  in  the  series  of 
thoughts  starting  from  A,  in  order  to  get  the  particular  idea 
or  wish  that  was  at  the  bottom  of  thinking  of  A [ i . e.,  at  the 
bottom  of  the  lapse]?”  And  he  answers  his  question  with 
the  words:  “He  stops,  in  practice,  when  he  finds  a significant 
complex.”  Once  more:  this  is  all  wrong!  As  the  detective 
stops  his  search  when  he  has  discovered  the  culprit,  so  the 
psychoanalyst  stops  when  he  has  discovered  not  “a  signi- 
ficant complex”  but  the  complex  responsible  for  the  lapse 
(which  may  be  a spontaneous  thought,  a slip  of  the  tongue 
or  of  the  pen,  a momentary  forgetting,  a temporary  ignor- 
ance, etc.)  - It  may  be  worth,  calling  the  reader’s  attention 
to  the  fact,  especially  since  Dr.  Woodworth  neglects  to  do 
so,  that  what  he  calls  “A”  is  not  any  thought  that  may 
chance  to  come  into  one’s  mind,  but  an  unintentional  sub- 
stitution (word  or  act)  for  something  intended,  or  a spon- 
taneous mental  presentation  which  is  apparently  unrelated 
to  the  thoughts  occupying  the  subject,  or  a forgetting  of 
something  known,  etc. 

Continuing  his  inquisition,  our  critic  asks:  “What 
determines  [the  psychoanalyst]  to  stop  just  when  the  com- 
plex is  reached,  and  not  before  or  after?  It  can  only  be,” 
says  he,  “as  far  as  I can  see,  from  a preconceived  notion 
that  some  complex  is  at  the  bottom  of  the  original  thought  or 
lapse.”  In  the  first  place,  let  us  point  out  that  strict  logic 
would  have  required  our  critic  to  say  “ a complex,”  and  not 
“the  complex.”  The  moment  he  says  “the  complex”  the 
reader  may  think  that  Dr.  Woodworth  means  the  causative 
complex  the  analyst  has  set  out  to  find,  and  he  may  then 
very  naturally  be  puzzled  at  the  question  why  a person 
should  stop  looking  for  something  that  he  has  found  and 
why  he  should  not  stop  before  he  has  found  it.  Of  course, 
the  analyst  stops  his  investigation  as  soon  as  he  has  dis- 
covered the  complex  that  the  subject’s  reason  and  feelings 
tell  him  is  at  the  bottom  of  the  lapse.  A mathematician 
considers  the  problem  solved  when  he  has  found  the  answer 
that  satisfies  the  requirements.  As  to  Dr.  Woodworth’s 
criticism  that  it  can  be  only  “ from  a preconceived  notion  that 
some  complex  is  at  the  bottom  of  the  original  thought  or 


S.  A.  Tannenbaum , M.  D. 


397 


lapse”  that  the  analyst  stops  when  he  has  discovered  the 
complex,  it  may  be  said  that  his  statement  would  be  quite 
correct  if  he  substituted  the  words  “from  a settled  conviction 
based  upon  experience ” for  the  words  “from  a preconceived 
notion.”  Freud’s  preconceived  notion  is  only  the  universal 
“preconception”  that  there  is  no  effect  without  a cause. 
In  the  absence  of  the  slightest  particle  of  evidence  that  this 
law  does  not  apply  to  psychical  phenomena  as  unalterably 
as  to  physical  phenomena,  he  is  fully  justified  in  his  assump- 
tion. And,  I submit,  Freud  is  proceeding  in  a wholly  logical 
and  scientific  manner  if,  on  the  basis  of  the  assumption,  he 
tests  every  apparently  causeless  or  accidental  psychic  phe- 
nomenon to  see  whether  a hidden  cause  or  motive  cannot  be 
discovered.  Years  of  experience,  corroborated  by  the  simi- 
lar experiences  of  hundreds  of  other  investigators,  have 
proved  indubitably — to  those  willing  to  repeat  Freud’s  ex- 
periments— that  the  law  of  cause  and  effect  does  apply  in- 
violably to  the  psychic  world  as  to  the  physical  world,  and 
that  the  method  of  free  associations  does  lead  to  the  dis- 
covery of  the  hidden  cause.  To  return  to  our  analogy,  a 
detective,  confronted  by  a crime,  takes  it  for  granted  that  a 
criminal  has  been  at  work  and  that  if  he  is  supplied  with 
an  adequate  number  of  clues  and  pursues  a proper  course, 
he  must  sooner  or  later  discover  the  culprit. 

In  the  light  of  all  this,  we  find  it  almost  incredible  that 
Dr.  Woodworth  should  say  that  if  the  Freudian  psychology 
is  based  on  the  aforementioned  assumption  it  “is  not  after 
all  founded  upon  the  analyses  obtained,  but  upon  precon- 
ceived notions,  or  perhaps,  it  would  be  better  to  say,  on  the 
attractiveness  of  the  conclusions  reached.  In  other  words, 
the  doctrine  of  the  significance  of  dreams,  lapses,  and  other 
complex  indicators  is  not  based  upon  the  evidence,  but  upon 
a certain  inherent  attractiveness  of  the  doctrine.”  It  is  as 
if  our  critic  had  said  that  Darwin’s,  Newton’s,  and  Galileo’s 
theories  were  not  based  upon  their  observations  but  upon 
preconceived  notions  or  on  the  attractiveness  of  the  con- 
clusions reached.  And  with  regard  to  Darwin  and  Galileo 
there  were  not  wanting  scientists,  professors  among  them, 
who  made  that  very  criticism.  Anyone  who  knows  any- 
thing about  the  history  of  psychoanalysis  knows  that  Freud 


398  Some  Current  Misconceptions  of  Psychoanalysis 

and  Breuer  approached  the  matters  they  examined  without 
any  preconceived  notions,  and  that  the  psychoanalytic 
doctrine  grew  up  in  the  school  of  experience.  And  Professor 
Woodworth,  though  he  is  half  willing  to  admit  this,  goes  on 
to  say,  “yet  the  doctrine  may  not  have  been  scientifically 
derived  from  the  evidence  which  he  [Freud]  brings  forward, 
but  may  have  been  a ‘happy  thought’  which  occurred  to 
him  in  connection  with  the  cases  he  met  and  so  gripped  him 
as  to  make  evidence,  for  him,  quite  a secondary  matter.  ” 
It  was  just  such  a “happy  thought” — oh,  happy  thinkers! — 
that  has  been  responsible  for  the  advancement  of  science 
in  each  of  its  many  spheres,  e.  g.,  physics  (Newton,  Watts), 
astronomy  (Galileo),  etc.  But  the  happy  thought  always 
came  to  men  who  had  the  rare  gift  of  observing  and  of  inter- 
preting without  prejudice  and  preconception  what  they  saw, 
and  who  knew  how  to  prove  the  correctness  of  their  dis- 
covery by  testing  the  world  of  phenomena  by  its  light, — 
while  the  rest  of  the  world,  professors  among  them,  followed 
limping  after. 

Inasmuch  as  Professor  Woodworth  again  returns  (on 
p.  7 of  the  reprint  of  his  criticism)  to  what  he  calls  Freud’s 
doctrine  that  “it  would  be  impossible  for  [thought]  A to 
lead  to  [thought]  B unless  B had  been  operative  in  the  pro- 
duction of  A,”  we,  too,  must  return  to  it.  Now,  Freud  does 
not  maintain,  and  has  never  maintained,  that  “if  A has 
occurred  in  the  process  of  thinking,  then  B,  reached  from  A 
as  the  starting  point  of  a free  movement  of  thought,  is  to  be 
presumed  to  have  been  a factor  in  the  original  production 
of  A.  ” Had  Freud  maintained  anything  even  half  so  ridicu- 
lous, Dr.  Woodworth  would  be  justified  in  saying  that  “this 
seems  to  turn  things  topsy-turvy,  since  what  A arouses  is 
conceived  as  arousing  A.  ” It  is  as  if  one  were  to  say  that  a 
scientist’s  gropings  for  the  solution  of  an  obscure  phenomenon 
caused  the  phenomenon.  Surely  no  one  says  that!  What 
Freud  does  maintain  is  this:  if  one  starts  from  an  imperfec- 
tion in  psychic  functioning  ( e . g.,  a lapse,  a forgetting,  a 
spontaneous  thought),  not  from  a thought  sufficiently  ac- 
counted for  by  the  play  of  conscious  forces,  with  the  purpose 
of  ascertaining  the  thought  responsible  for  the  disturbance 
and  pursues  the  method  of  free  associations,  one  will  be  led 


S.  A.  Tannenbaum , M.  D. 


399 


to  the  underlying  motive  or  complex.  This  is  exactly 
parallelled  by  a scientist’s  investigation  of  the  conditions 
(causes)  that  gave  rise  to  an  unexpected  phenomenon  (A). 
There  is  no  question  then  of  the  thoughts  “aroused”  by  A 
really  “arousing”  A.  The  thoughts  or  associations,  the 
recollections,  that  one  evokes — the  facts  one  brings  to  light — 
when  one  pursues  a chain  of  associations  from  lapse  A (not 
merely  “thought  A”)  are  in  no  sense  “aroused  by  A.”  And 
yet  it  is  perfectly  true  that  the  facts  thus  brought  to  light, 
not  thus  “aroused,”  are  responsible  for,  account  for,  the 
lapse  A.  The  Professor’s  error  results  from  an  abuse  of 
words;  he  uses  the  words  “arouse”  and  “arousing”  in  senses 
which  they  do  not  have  and  in  different  senses  in  each  of  the 
phrases  “what  A arouses”  and  “arousing  A.”  He  is  guilty 
of  a similar  error  in  logic  in  the  way  he  uses  the  word  “what” 
in  the  phrase  “what  A arouses,”  for  he  leaves  it  doubtful 
whether  he  means  it  for  “the  thoughts”  or  “the  facts.” 
To  make  this  clearer,  let  us  paraphrase  the  two  sentences 
quoted  from  our  crilic  in  the  light  of  the  analogy  already 
employed:  “Freud  somewhere  says  that  it  would  be  impos- 
sible for  a crime  (A)  to  lead  a detective  to  the  guilty  agent 
(B)  unless  B had  been  operatfve  in  the  production  of  A. 
This  seems  to  turn  things  topsy-turvy,  since  what  A arouses 
[i.  e.,  the  search  for  the  guilty  agent]  is  conceived  as  arous- 
ing A [i.  e.,  as  causing  the  crime].”  Presented  in  this  way, 
it  is  clear  that  our  critic’s  first  sentence  is  true  and  that  Freud 
is  right;  whereas  the  second,  owing  to  the  improper  use  of 
the  word  “arouse,”  is  wholly  false.  In  other  words,  Dr. 
Woodworth  has  disproved  something  that  did  not  need  dis- 
proof and  that  no  one  has  asserted. 

That  there  may  be  no  mistake  about  this,  let  us  illus- 
trate the  anlysis  of  a lapse.  Mr.  M.  F.,  an  American  busi- 
ness man,  fairly  well  educated  (he  reads  newspapers  and 
scientific  books),  was  proprietor  of  an  incorporated  business 
two  years  ago.  More  than  a year  ago  this  concern  put  up 
its  shutters,  involving  him  in  a loss  that  represented  (for 
him)  a large  sum.  Having  failed  to  notify  the  authorities  of 
the  dissolution  of  his  business,  he  was  required  to  appear 
at  the  Marshal’s  Office  to  pay  a tax  ($13.51).  Both  M.  F. 
and  his  wife  grumbled  at  having  to  pay  taxes  on  a business 


400  Some  Current  Misconceptions  of  Psychoanalysis 

that  had  involved  the  loss  of  $1,500.00  in  a few  months  and 
which  had  been  so  long  out  of  existence — it  was  throwing 
good  money  after  bad,  they  said.  On  the  appointed  day, 
Mr.  M.  F.  appeared  in  the  Municipal  Building  and,  on  en- 
tering it,  asked  to  be  directed  to  the  Sheriff’s  Office.  When 
he  was  told  where  to  go,  it  suddenly  dawned  upon  him  that 
he  had  made  a mistake:  he  had  meant  to  say  “Marshal’s 
Office.  ” He  knew  perfectly  well  the  difference  between  the 
duties  of  the  marshal  and  the  sheriff,  and  on  leaving  his  own 
office  had  had  the  marshal’s  office  clearly  in  mind.  The 
analysis  of  this  lapse  brought  out  all  the  above  facts  about 
the  dissolved  corporation  and  the  reluctance  to  pay  the  tax, 
also  the  fact  that  the  subject  knew  that  one  goes  to  the  sheriff 
to  collect  money  or  to  put  claims  in  his  hands  for  collection. 
Interpretation:  the  subject  disliked  going  to  the  marshal 
and  would  have  preferred  going  to  the  sheriff.  Surely  no 
one  can  say,  by  any  stretching  of  the  word  “arouse”,  that 
the  above  facts  were  “aroused”  by  the  lapse;  they  were 
brought  out  only  in  our  investigation  of  the  lapse  and  were 
undoubtedly  the  cause  of  the  lapse.  The  slip  of  the  tongue 
(A)  did  not  arouse  B (the  unpleasant  facts),  though  B did 
cause  the  slip. 

Owing  to  the  fact  that  “shifts  of  thought  are  the  rule,” 
that  “in  the  course  of  a revery  or  other  free  associative 
process”  one  tends  “to  get  quite  away  from  the  context  of 
one’s  starting  point,”  and  that  a multitude  of  associative 
reactions  are  possible,  and  that  “shifting  of  the  topic  is 
characteristic  of  uncontrolled  thinking,”  Professor  Wood- 
worth  concludes  that  it  is  “utterly" impossible  to  accept  the 
■fundamental  proposition  on  which  the  Freudian  conclusions 
as  to  the  latent  content  of  dreams,  lapses,  etc.,  are  based.  ” 
To  me  there  have  always  seemed  to  be  two  fundamental 
propositions  involved:  (1)  that  all  psychic  phenomena, 

including  lapses,  dreams,  etc.,  have  a psychic  cause;  (2) 
that  the  psychic  cause  (complex)  can  be  discovered  by  the 
method  of  free  associations  carried  out  in  a certain  way.  I 
take  it  for  granted  that  Dr.  Woodworth  has  reference  to 
the  second  of  these  propositions.  That  in  ordinary  think- 
ing shifts  of  thought  are  the  rule  admits  of  no  dispute;  but 
to  assert  this  is  a long  way  from  saying  that  one  may  not 


S.  A.  Tannenbaum , M.  D.  401 

discover  a certain  complex  by  the  method  of  free  associa- 
tions. For  the  purpose  of  our  discussion  we  need  not  even 
take  advantage  of  Professor  Woodworth’s  admission  that 
“undoubtedly  there  are  cases  where  the  thought  hovers 
about  a given  point.”  “That  in  the  course  of  a reverie  or 
other  free  association  one  tends  to  get  quite  away  from  the 
context  of  one’s  starting  point”  is  also  true;  but  investiga- 
tion will  show  that  all  the  thoughts  so  aroused  are  related 
and  definitely  linked  to  one  another  by  certain  bonds  or 
associations  and  form  a continuum, — a fact  that  tells  decided- 
ly in  favor  of  Freud’s  theory.  It  is  also  true  that  a multi- 
tude of  associative  reactions  is  possible;  but  experience 
proves  that  the  actual  reactions  chosen  from  this  multitude 
are  determined  by  the  operative  complex  or  complexes,  and 
that  the  subject  can  not  (without  betraying  himself)  volun- 
tarily choose  associative  reactions  unrelated  to  the  operative 
complex.  That  “shifting  of  the  topic  is  characteristic  of 
uncontrolled  thinking”  can  be  admitted  dnly  if  one  knows 
what  Dr.  Woodworth  means  by  the  words  “shifting  of  the 
topic.  ” If  he  means  that  the  thoughts  move  from  one  sub- 
ject to  another  he  is  right;  but  if  he  means  that  the  thoughts 
move  on  to  unrelated  subjects,  he  is  wrong.  It  is  a sufficient 
answer  to  all  these  objections  that  the  daily  experience  of 
numerous  psychoanalysts  the  world  over  shows  that  the 
difficulties  attending  such  a course  of  free  associations  as 
Freud  has  in  mind  can  be  overcome,  and  that  when  they 
are  so  overcome  it  is  usually  not  a difficult  matter  for  the 
mind  to  travel  a backward  course  from  a lapse  to  the  causal 
complex. 

“If  it  were  possible,”  says  Dr.  Woodworth,  “to  get  to 
the  complexes  only  by  starting  with  a drea-m  or  complex 
indicator,  then,  indeed,  some  special  connection  could  be 
believed  to  exist  between  them;  but,  as  a matter  of  fact, 
you  can  take  a perfectly  arbitrary  starting-point,  such  as  a 
word  occurring  in  the  course  of  smooth-running  waking 
thought,  and,  proceeding  according  to  Freud’s  instructions, 
reach  a complex  just  the  same.”  This  is  as  much  as  to  say, 
recurring  to  our  analogy,  that  if  it  were  possible  to  discover 
evil-doers  only  by  starting  from  a crime  or  a clue,  then,  in- 
deed, some  special  connection  could  be  believed  to  exist 


402  So  me  Current  Misconceptions  of  Psychoanalysis 

between  them;  but,  as  a matter  of  fact,  one  can  take  a per- 
fectly arbitrary  starting-point,  such  as  a commonplace 
action,  and,  proceeding  according  to  the  chief’s  instructions, 
find  a culprit  just  the  same.  This  is  perfectly  true  but  it 
has  no  bearing  on  the  question  of  how  to  discover  the  culprit 
guilty  of  a particular  misdemeanor.  The  object  of  Freud’s 
method  is  not  the  discovery  of  complexes,  but  the  discovery 
of  the  particular  complexes  which  are  at  the  bottom  of,  or 
responsible  for,  certain  dreams,  lapses,  etc.  The  fact  that  a 
detective  may  accidentally  come  upon  a pick-pocket  does 
not  in  any  way  exclude  the  possibility  of  his  discovering 
the  perpetrator  of  a particular  crime  or  the  person  indicated 
by  certain  finger-prints;  nor  does  it  deprive  of  all  force  the 
conclusions  reached  by  expert  detectives  as  to  finger-prints 
and  clues.  So,  too,  the  ability  to  discover  complexes  at 
random  has  absolutely  no  bearing  on  the  question  of  the 
validity  of  Freud’s  conclusions  as  to  dreams  and  complex 
indicators.  The  fact  that  even  commonplace  actions  have 
motives  is  no  reason  for  denying  motives  to  criminal  actions. 

A splendid  illustration  of  how  easily  bias  results  in  bad 
logic  is  furnished  by  the  following  argument:  “If  the  complex 
[Query:  which  complex?]  is  held  to  have  produced  the  dream 
or  complex  indicator  because,  on  starting  with  the  latter, 
the  former  is  reached,  by  the  same  logic  we  must  conclude 
that  the  complex  [Same  query]  operates  in  the  production 
of  the  most  smooth-running  of  waking-thoughts;  and  then 
the  distinctions  between  lapses  and  smooth-running  think- 
ing, and  between  dreams  and  waking  thought  vanish  into 
thin  air  and  with  them  a large  share  of  the  whole  Freudian 
psychology.”  That  is  to  say:  If  John  Smith  is  held  to  have 
committed  a certain  crime  or  to  have  left  a certain  clue  be- 
hind because,  on  starting  with  the  latter,  the  former  (John 
Smith)  is  reached,  by  the  same  logic  (!)  we  must  conclude 
that  John  Smith  operates  in  the  production  of  everything 
that  goes  on  in  the  community;  and  then  the  distinctions 
between  crimes  and  honest  actions  vanish  into  thin  air!  Just 
as  every  action  presupposes  an  agent  and  a motive,  so  every 
crime  presupposes  an  agent  and  a criminal  motive;  and  just 
as  some  disturbers  of  the  peace  do  their  work  in  the  dark 
and  long  remain  unknown,  so  certain  complexes  (repressed 


S.  A.  Tannenbaum,  M.  D. 


403 


motives)  work  without  showing  their  visages  and  long  re- 
main unknown;  but  with  adequate  clues  both  may  be  dis- 
covered. Our  critic’s  error  resulted  from  his  unfortunate 
use  of  the  words  “the  complex;”  had  he  said  “a  complex” 
in  the  first  clause  and  “some  other  complex”  in  the  second, 
he  would  have  seen  that  he  was  giving  expression  to  a truth 
and  not  to  an  absurdity. 

We  are  then  treated  to  the  following  bit  of  misrepre- 
sentation: “As  the  procedure  already  described  usually  brings 
the  subject  to  a sexual  complex,  the  prevailing  type  of  com- 
plexes is  concluded  to  be  sexual.”  What  Dr.  Woodworth 
fails  to  tell  his  readers  is  that  this  statement  applies  only 
to  the  psychoneuroses  and  to  many  dreams,  but  not  to 
lapses,  forgettings,  etc. 

“Psychological  experimenters  (as  Messer  and  Koffka) 
have  frequently  observed  that  it  is  very  difficult  to  secure  a 
really  free  association.”  Just  what  kind  of  an  association 
is  meant  by  “a  really  free  association”  we  are  not  told. 
But  it  suffices  us  to  know  that  in  actual  experience  the  free 
associations  are  usually  found  to  be  perfectly  adequate  to 
attain  the  object  intended.  Most  patients  have  consider- 
able difficulty  at  first  in  learning  to  associate  freely;  but,  on 
the  whole,  the  operation  is  readily  mastered.  Fortunately 
very  few  things  are  so  difficult  that  they  may  not  be  learned. 
“Absolutely  unguided  movement  of  thought  is  very  un- 
usual,” as  our  critic  says;  but  he  should  have  added  “under 
ordinary  conditions.”  During  psychoanalysis  and  during 
reveries  it  is  not  unusual. 

Our  critic  implies  that  the  sexual  is  suggested  to  our 
patients.  He  says:  “The  subject  is  warned  time  and  time 

again  that  he  must  keep  back  nothing  if  he  wishes  the  treat- 
ment to  succeed.  It  is  easy  to  see  that  such  instructions 
tend  to  arouse  a definite  set  of  mind  towards  that  which  is 
private  and  embarrassing;  and  this  easily  suggests  the  sex- 
ual.” The  answer  to  this  is  that  it  is  partly  true,  but  only 
partly.  In  the  case  of  female  patients  it  may  be  that  the 
sexual  is  thus  suggested;  but  in  the  case  of  male  patients  I 
have  always  found  that  they  thought  the  analyst  referred 
to  criminal  actions.-  If  the  sexual  comes  to  the  patient’s 
mind  under  the  circumstances  it  is  due  only  to  the  fact  that 


404  Some  Current  Adisconceptions  of  Psychoanalysis 

the  sexual  is  there.  One  might  with  as  much  reason  as  Dr. 
Woodworth  displays  say  that  the  bad  odors  accompanying 
certain  chemical  experiments  are  suggested  by  the  chemist, 
or  that  the  penitent’s  sins  are  suggested  by  the  confessor. 
But,  as  a matter  of  fact,  both  sexes  have  to  be  under  treat- 
ment a long  time  before  they  confess  any  sexual  or  criminal 
transgressions.  No  matter  what  the  analyst  says,  the 
patients  long  continue  to  assure  him  how  innocent,  in  thought 
and  act,  they  are  and  always  have  been.  That  “the  subject 
is  more  or  less  subtly  influenced  to  direct  his  thoughts  toward 
the  sexual”  and  that  he  therefore  finds  sexual  complexes  is 
not  true.  Even  when  the  psychoanalysts  have  been  very 
cautious  not  to  suggest  anything  sexual,  the  patients  almost 
invariably  finally  find  the  explanation  for  their  troubles  in 
the  sexual  sphere  (using  the  word  “sexual”  in  the  broad, 
Freudian  sense).  And  we  have  no  hesitation  in  saying  that 
Dr.  Woodworth  will  not  be  able  to  verify  the  following  state- 
ment of  his:  “If  a psychoanalyst  of  different  convictions 
should  more  or  less  subtly  convey  the  important  things  to 
look  for  were  in  the  line  of  self-assertion,  or  in  the  line  of 
competition  in  the  struggle  for  existence  and  social  standing, 
or  in  the  line  of  anger  and  irritation,  he  would  certainly  lead 
his  subjects  to  find  complexes  of  these  types.”  He  is  wel- 
come to  the  experiment.  As  a matter  of  fact,  however, 
some  such  complexes  emanating  from  the  ego-impulses  arc 
almost  always  found  co-operating  with  complexes  from  the 
sexual  sphere,  and  only  in  the  rarest  instances  is  a neurosis 
based  on  complexes  emanating  exclusively  from  one  of  these 
spheres. 

Having  disposed,  as  he  thinks,  of  what  he  calls  “the 
first  method  of  psychoanalysis,”  that  of  free  associations, 
Dr.  Woodworth  goes  on  to  demolish  what  he  calls  the  second 
method,  the  method  of  fixed  symbolism,  “in  which  the 
psychoanalyst  works  with  comparatively  little  contribution 
from  the  subject,  by  the  aid  of  fixed  symbols.  ” To  a 
psychoanalyst  such  a grossly  incorrect  statement  of  the 
technique  might  well  be  sufficient  justification  for  throwing 
the  Professor’s  criticism  aside  without  further  notice. 
Nothing  in  the  Freudian  psychology  warrants  an  analysis  by 
the  aid  of  fixed  symbols.  Not  even  the  boldest  Freudian, 


S.  A.  Tannenbaum , M.  D. 


405 


not  even  that  artist  in  dream  interpretation,  Stekel,  dares  to 
rely  on  such  an  uncertain  and  variable  quantity  as  a symbol 
for  his  interpretation  of  a symptom  or  a dream.  A more 
than  merely  superficial  familiarity  with  the  writings  of  the 
Freudian  school  would  probably  have  convinced  our  critic 
that  neither  Freud  nor  any  pupil  of  his  relies  upon  a fixed 
symbolism  or  “a  table  of  equivalents  derived  from  previous 
psychoanalytic  experience.”  Freud  has  never  retracted  or 
modified  his  conviction  that  symbols  are  an  individual 
matter  and  that  what  is  signified  by  a given  symbol  can  be 
determined  only  by  an  analysis  of  the  individual  employing 
the  particular  symbol.  That  this  is  the  current  view  is 
proved  by  the  following  quotations,  one  from  Dr.  William 
White’s  recently  published  book,  “The  Mechanisms  of 
Character  Formation”  (to  which  Professor  Woodworth 
refers  in  his  criticism)  and  one  from  my  own  essay  on  the 
technique  of  dream  interpretation  ( American  Journal  of 
Urology  and  Sexology , May.  1917,  pp  206-7  and  211).  Let 
us  quote  the  latter  first  as  being  more  complete:  “The  in- 
terpretation of  a dream  from  its  symbols  alone  would,  if  it 
were  possible , reveal  only  one  meaning  of  the  message  from 
the  unconscious, — a message  which  in  adults,  especially 
in  neurotics,  is,  in  all  probability,  overdetermined.  In  the 
second  place,  the  therapeutic  effect  of  a dream  analysis,  our 
only  desideratum,  results  not  from  a knowledge  of  the  mean- 
ing of  the  dream  but  from  overcoming  the  patient’s  resist- 
ances to  the  realization  of  the  presence  and  significance  of 
forbidden  desires  forced  out  of  consciousness  by  the  en- 
dopsychic  censor. — There  is  no  surer  way  of  breaking  down 
the  neurotic’s  resistances  to  dream  interpretation  than 
letting  him  discover  the  presence  and  meaning  of  symbols 
in  his  dreams  for  himself  and  from  his  free  associations. — A 
conscientious  psychoanalyst  will  rather  leave  a dream 
uninterpreted  than  hazard  an  interpretation  from  its  sym- 
bols.— Notwithstanding  the  fact  that  owing  to  the  influence 
of  current  jests  and  witticisms,  biblical  lore,  literary  usage, 
etc.,  certain  words  and  objects  have  almost  universally 
acquired  a symbolic  signification,  there  are  undoubtedly 
many  individuals  who  do  not  attach  a symbolic  meaning  to 
these  familiar  terms  and  objects,  to  whom  a nightingale  is 


406  Some  Current  Misconceptions  of  Psychoanalysis 

only  a nightingale,  no  matter  what  it  may  be  to  readers  of 
Boccaccio.  This  individual  factor  must  always  be  reckoned 
with  by  the  analyst.  The  primrose  may  be  only  a little 
golden  flower  to  a great  many  people,  but  it  is  much  more  to 
a Wordsworth.  Even  racial  and  national  factors  must  be 
considered  by  the  scientific  analyst:  white  is  not  everywhere 
the  symbol  for  purity,  black  for  mourning,  or  a veil  for 
chastity.  Linguistic  and  religious  influences,  too,  unques- 
tionably play  an  important  role  in  affixing  symbolic  mean- 
ings to  certain  words.  No  one  knows  better  than  the 
practised  psychoanalyst  that  many  individuals  employ  a 
symbolic  vocabulary  that  is  peculiarly  their  own  and  that 
is  the  product  of  their  occupation,  their  experiences,  their 
associations,  etc.  He  would  indeed  be  bold  who,  in  the  face 
of  only  these  difficulties  (there  are  others),  would  easily  pre- 
sume to  interpret  a patient’s  dream  from  his  symbols  rather 
than  from  his  free  associations.” 

Dr.  White  (cf.  his  book,  p.  107)  thus  sums  up  the  matter: 
“In  actual  work,  however,  [the]  appeal  to  the  individual  is 
practically  always  necessary , because  no  matter  how  pro- 
found and  universal  the  meaning  may  be,  it  is  always  clothed 
in  the  individual’s  personal  experiences.  This,  of  course, 
must  be  so.  The  individual  is  limited  in  the  form  of  his 
expression  by  the  actual,  available  material  in  his  psyche." 
Freud  himself  puts  the  matter  thus  (in  the  third  edition  of 
his  books  on  dreams,  p.  210):  “One  must  bear  the  peculiar 
plasticity  of  psychic  material  in  mind.  A symbol  in  a 
dream  may  now  and  then  have  to  be  interpreted  literally, 
and  not  symbolically;  at  other  times  a dreamer  may  exercise 
his  right  to  employ  as  a possible  sexual  symbol  special 
material  dwelling  in  his  own  stock  of  memories  which  is  not 
generally  so  employed.  And  the  customary  sexual  symbols 
do  not  invariably  have  the  same  meaning.  ” 

Considering  the  above  and  other  restrictions  thrown 
around  the  interpretation  of  symbols  one  must,  to  put  it 
mildly,  have  a very  shadowy  knowledge  of  the  theory  and 
practice  of  psychoanalysis  to  say  that  certain  dream  elements 
are  interpreted  by  reference  to  a table  of  equivalents.  And 
the  above  quotation  from  Freud  is  a sufficient  answer  to 
Professor  Woodworth’s  very  unfair  assertion  that  Freud, 


S.  A.  Tannenbaum,  M.  D. 


407 

“following  the  lead  of  some  of  his  pupils,  has  come  to  believe 
that  certain  objects  are  fixed  symbols  for  certain  other 
objects  or  conditions,  and  that  it  is  no  longer  necessary  to 
establish  the  significance  of  certain  dream  elements  by  the 
free  movement  of  thought.  ” 

Dr.  Woodworth  is  therefore  guilty  of  gross  errors  and 
exaggerations  when  he  makes  the  broad  assertion  that  to  a 
Freudian  “the  snake  is  always  a male  phallic  symbol,  a gar- 
den a symbol  for  the  female  genitals,  and  stairs  a symbol  for 
coitus.”  As  we  have  seen,  Freud  distinctly  says  that  a 
dream  element  may  stand  for  itself  and  not  call  for  a symbolic 
interpretation.  In  the  second  place,  every  psychoanalyst 
knows  that  a symbol  may  stand  for  a great  many  different 
things  in  literature,  dreams,  etc.  Thus,  for  example,  in  the 
essay  of  mine  previously  quoted  I say  (p.  209):  “all  these 
symbols  may  be  overdetermined  and  symbolise  many  things, 
e.  g.,  a dog  may  stand  for  a certain  individual,  for  fidelity, 
shamelessness,  etc.;  a cat  for  a woman,  a man,  treachery, 
cunning,  etc.  ” There  is  no  warrant  then  for  Dr.  Wood- 
worth’s statement  that  to  the  psychoanalyst  a snake  is 
always  a male  phallic  symbol.  He  contends,  quite  correctly, 
that  the  snake  is  “a  natural  [!]  symbol  for  sinuousness,  or 
slyness,  or  widom,  or  danger,  ” to  one  acquainted  with  its 
characteristics.  But  it  requires  no  great  stretch  of  the 
imagination,  nor  very  profound  learning,  especially  to  one 
acquainted  with  the  biblical  account  of  creation,  to  find  it 
also  a “natural  symbol”  for  sensual  pleasure,  sexual  passion, 
sin,  and  the  phallus.  Our  critic’s  statement  that  “only 
in  one  of  its  many  aspects  is  [the  snake]  a phallic  symbol” 
is  utterly  incorrect.  The  physical  characteristics  of  the 
snake  and  its  activities — it  is  long,  cylindrical,  smooth, 
sleek  and  sinuous,  erects  its  head,  has  a predilection  for  dark 
caverns,  emits  a dangerous  substance — suggest  the  phallus 
and  its  function  from  so  many  aspects  that  even  the  simplest 
intelligences  (the  readiest  to  find  such  analogies)  have  been 
struck  with  the  resemblances.  In  the  fantasy  products  of 
primitive  man,  e.  g.,  even  in  our  Bible,  the  snake  is  re- 
sponsible for  the  introduction  of  sin  into  the  world.  Recent 
biblical  exegesis  (by  non-Freudians)  has  shown  that  in  the 
story  of  Adam  and  Eve  the  snake  symbolises  the  phallus. 


408  Some  Current  Misconceptions  of  Psychoanalysis 

Many  ancient  myths  and  fairy  tales  acquire  an  acceptable, 
intelligible  meaning  only  if  “snake”  is  interpreted  as  “phal- 
lus.” We  therefore  utterly  repudiate  the  Professor’s 
statement  (p.  n)  that  one  who  has  sufficient  intelligence  to 
find  the  snake  a natural  symbol  for  sinuousness,  or  slyness, 
or  wisdom,  or  danger,  will  find  considerable  difficulty  in 
seeing  ‘the  particular  characteristic’  that  has  made  it  a 
phallic  symbol  to  the  initiated.  On  the  contrary,  one  would 
have  to  be  unusually  obtuse,  especially  if  he  had  a living 
acquaintance  with  snakes,  not  to  hit  upon  the  resemblance 
sooner  or  later.  In  this  connection  it  must  not  be  overlooked 
that  the  folk  mind,  repeated  in  schooi  children  about  the 
age  of  puberty,  is  amazingly  quick  to  detect  analogies  to  the 
sexual  organs  and  sexual  processes  where  the  cultured  mind, 
more  accustomed  to  ratiocination,  and  because  of  a larger 
range  of  interests  and  sublimation,  is  not  so  likely  to  see  any. 
That  is  why  the  languages,  myths,  sagas,  and  religions  of 
primitive  peoples  are  saturated  with  sexual  symbolisms. 
For  proof  of  this  statement  in  the  domain  of  language  I refer 
to  the  brilliant  writings  of  Kleinpaul. 

An  illustration  of  the  method  of  applying  the  knowledge 
concerning  symbols  obtained  from  the  analysis  of  a large 
number  of  cases  may  not  be  amiss.  A male  patient,  long 
married,  suffering  from  pathological  jealousy  and  de- 
pression, has  a dream  in  the  course  of  which  he  finds  that  a 
ring  is  too  large  for  his  finger.  He  can  associate  nothing 
with  this  particular  dream  element.  I venture  the  question 
whether  this  obscure  dream  fragment  would  not  acquire  a 
meaning  if  we  substituted  “vagina”  for  “ring”  and  “penis” 
for  “finger.”  At  once  his  face  lights  up  and  in  a burst  of 
confidence  he  assures  me  that  ever  since  his  wife’s  (instru- 
mental) confinement  fifteen  years  ago,  resulting  in  a perineal 
laceration,  the  anatomic  conditions  have  unhappily  fitted 
the  symbolism  in  a way  not  needing  elucidation  here.  She 
had  a leucorrhoea  also  (in  another  dream  he  dreamt  that  the 
street  was  too  wet),  but  he  lacked  the  nerve  to  speak  to  her 
of  these  things  and  suffered  in  silence.  I instructed  him  to 
take  his  wife  into  his  confidence  atnd  to  have  her  put  herself 
under  treatment.  She  took  his  advice  and  was  cured — and 
so  was  he.  I venture  the  assertion  that  this  mode  of  inter- 


S.  A.  Tannenbaum , M.  D.  409 

preting  the  dream  was  perfectly  scientific  though  it  was  not 
based  on  a statistical  study  of  the  frequency  with  which 
“ring”  is  employed  as  a sexual  symbol  by.  an  American 
salesman  born  in  America  and  educated  in  Switzerland 
(as  my  patient  was).  Having  found  by  experience  that 
humanity  is  apt  to  associate  things  that  are  round  or  hollow 
with  a particular  part  of  the  female  anatomy,  we  tentatively 
apply  our  knowledge  to  any  new  mental  presentation  and 
if  by  this  procedure  we  obtain  an  intelligible  meaning  (and 
affective  confirmation)  where  there  was  none  before  we 
rightly  conclude  that  we  have  interpreted  the  new  presenta- 
tion by  the  aid  of  our  formula  and  maintain  that  our  form- 
ula or  law  has  received  additional  corroboration  from  the 
new  finding. 

In  discussing  the  emotions  in  dreams  (pp.  13-14),  Prof. 
Woodworth  shows  himself  uninformed  of  what  Freud  has  said 
on  the  subject  in  his  book  on  the  interpretation  of  dreams. 
In  A.  A.  Brill’s  translation  of  the  3d  edition,  pp.  364-389,  we 
find  a discussion  of  the  very  problems  that  Dr.  Woodworth 
now  avails  himself  of  in  his  attempt  to  discredit  the  psycho- 
analytic theory.  Freud  long  ago  saw  the  difficulties  men- 
tioned by  Dr.  Woodworth  and  tried  to  meet  them  tp  the 
best  of  his  ability  in  the  light  of  the  knowledge  at  his  com- 
mand. Neither  Freud  nor  any  of  his  disciples  pretends 
that  either  the  dream  problem  or  the  neurosis  problem  has 
been  completely  solved.  There  is  much  work  left  for  psycho- 
analysts and  psychologists  to  do.  But  let  us  examine  some 
of  our  critic’s  objections  and  assertions  in  detail.  He  says 
(p.  14) : “ It  is  very  curious,  if  the  dream  is  actually  a working 
out  of  unconscious  tendencies  strongly  charged  with  emo- 
tion, that  its  emotional  tone  should  be  so  mild  and  superficial. 
This  would  easily  be  understood  if  the  dream  were  what  it 
seems  to  be,  a relatively  superficial  play  of  fancies  but  not 
if  it  is  as  deeply  motived  as  Freud  supposes  it  to  be.”  In 
the  first  place,  Professor  Woodworth,  like  many  others, 
greatly  exaggerates  the  shallowness  of  the  emotions  in 
dreams.  It  is  undoubtedly  true  that  many  dreams  seem 
to  be  lacking  in  emotion,  but  I believe  that  careful  inquiry 
will  show  that  most  dreamers  are  conscious  of  very  intense 
and  varied  emotions  in  their  dreams  and  that  the  emotional 


410  Some  Current  Misconceptions  of  Psychoanalysis 

shallowness  is  apparent  only  and  due  merely  to  the  investi- 
gator’s failure  to  pay  as  much  attention  to  the  dream  emo- 
tions as  to  the  dream  thoughts.  But,  even  admitting  this, 
there  is  still  a large  body  of  emotionally  colorless  dreams 
whose  latent  content  includes  thoughts  of  great  emotional 
significance.  Freud,  who  has  herein  too  anticipated  his 
critics  and  proved  himself  the  acutest  of  the  objectors  to  his 
theories,  supplies  (/.  c .)  several  solutions  to  this  “enigma  of 
the  dream”  (as  he  calls  it).  It  is  evident,  says  he,  that  in 
these  dreams  “a  suppression  of  the  affects  has  taken  place” 
chiefly  as  a result  of  the  sleeping  condition.  To  the  censor 
must  also  be  assigned  a share  in  dampening  or  restraining 
the  emotions.  Analysis  has  shown  that  in  the  latent  content 
of  many  dreams  contrary  and  antagonistic  thoughts  occur 
side  by  side,  and  often  even  fused  into  a unity;  and  it  is 
extremely  probable  that  the  contrary  emotions  accompany- 
ing these  thoughts  very  largely,  and  often  wholly,  neutralize 
each  other.  The  inversion  of  the  emotions  in  some  dreams, 
i.  e.  ‘the  substitution  of  one  emotion  for  its  opposite,’  is 
probably  another  factor  in  weakening  the  manifest  emotion; 
a simulated  passion  is  never  as  intense  as  that  which  comes 
directly  from  the  heart.  The  bipolar  attitude  of  the  dreamer 
to  many  of  his  problems  also  serves  to  dilute  or  neutralize 
the  latent  emotions.  The  wish  to  sleep  undoubtedly  also 
operates  to  restrain  the  emotions,  just  as  it  inhibits  the 
impulse  to  muscular  activity:  if  the  dream  emotions  attained 
the  full  intensity  required  by  the  latent  thoughts  the  dreamer 
would  be  very  likely  to  awake.  And  I have  little  doubt 
that  in  most  of  our  dreams  we  are  dimly  aware  of  the  fact 
that  we  are  sleeping  and  that  it’s  all  only  make-believe.  A 
day-dreamer  also  inhibits  the  acting  of  his  fantasies  and 
curbs  the  emotional  reactions  to  them.  If  the  emotion 
in  the  fantasy  equaled  the  latent  emotions,  the  dreamer 
would  find  it  difficult  not  to  proceed  to  action  instead  of 
contenting  himself  with  the  fantasy. 

Professor  Woodworth  seems,  very  strangely,  to  have 
overlooked  the  fact  that  if  a dream  were,  as  he  assumes  it  to 
be,  nothing  but  “a  relatively  superficial  play  of  the  fancies,” 
instead  of  a deeply  motived  psychic  product,  we  should  not 
find,  as  we  do,  dreams  which  have  a trivial  ideational  con- 


S.  A.  Tannenbaum,  M.  D. 


411 

tent  charged  with  very  intense  emotions  and  other  dreams  in 
which  the  manifest  emotion  is  grotesquely  incongruous  with 
the  manifest  dream  content.  By  way  of  illustration  I briefly 
cite  the  following  dreams,  with  hints  as  to  their  meaning:  (1) 
An  old  man,  impotent,  depressed  at  the  thoughts  of  approach- 
ing death,  dreamt  that  he  could  not  turn  on  the  gas  even 
with  his  wife’s  assistance  (renew  his  sexual  life)  and  laughed 
(cried)  hysterically,  so  that  his  wife  had  to  wake  him.  (2) 
A man,  42  years  old,  totally  impotent  since  his  marriage  (13 
years  ago),  dreams  he  is  running  up  a certain  street;  no 
emotion;  he  awakes  with  a delightful  sexual  feeling  over  the 
whole  body  and  normal  emissio  nocturnalis. 

Proceeding  from  the  Freudian  doctrine  that  “the  dream 
is  regarded  as  the  equivalent  of  the  neurotic  symptom,  to 
the  extent  at  least  that  both  are  expressions  of  suppressed 
tendencies,  ” our  critic  argues  that  if  this  were  true  “we  should 
expect  to  find  the  dream  heavily  charged  with  emotion; 
dreams  should  be  like  neurotic  symptoms  in  this  respect.” 
We  venture  to  assert  that  the  difficulty  of  reconciling  these 
facts  with  each  other  is  more  apparent  than  real  and  that 
it  is  our  critic’s  inadequate  knowledge,  and  not  the  Freudian 
theory,  that  is  at  fault.  In  the  first  place,  it  does  not  at  all 
follow  that  because  dreams  resemble,  or  are  “very  closely 
analogous  to,”  neurotic  symptoms  in  certain  respects  that 
therefore  these  two  psychic  creations  (symptoms  and  dreams) 
must  resemble  each  other  in  all  other  respects.  If  they  did, 
they  would  be  identical.  And,  further  more,  it  is  not  true 
that  (all)  neurotic  symptoms  are  “heavily  charged  with 
emotion.”  Professor  Woodworth  seems  to  have  forgotten 
that  many  neurotic  manifestations  are  wholly  lacking  in 
“affective  tone,”  and  that  it  is  only  in  the  obsession  neuroses 
that  there  is  “the  apparently  disproportionate  emotion  in 
the  neurotic’s  manner  of  dealing  with  trivial  matters,”  and 
that  even  in  these  there  is  no  proportion  kept  between  the 
manifest  emotion  and  the  latent  emotions.  The  reasons  for 
the  subdued  tone  of  the  emotions  in  neurotic  symptoms  are 
probably  very  much  the  same  as  in  dreams.  In  addition 
to  this  it  must  be  borne  in  mind  that  dreams  and  symptoms 
have  different  functions,  serve  different  purposes,  and  that 
they  may  therefore  be  expected  to  differ  in  certain  respects, 


412  Some  Current  Misconceptions  of  Psychoanalysis 

especially  as  regards  their  emotional  tone.  Thus,  one  of  my 
patients  suffering  from  complete  sexual  anaesthesia  as  re- 
gards coitus,  was  troubled  with  a slight  burning  sensation 
at  the  tip  of  the  tongue  which  he  attributed  to  smoking  and 
to  which  he  paid  almost  no  attention  until  he  happened  to 
mention  it  quite  accidentally.  Analysis  of  this  “trivial 
symptom”  brought  intensely  affective  complexes  to  light. 
He  feared  the  development  of  cancer  of.  the  tongue  from 
smoking;  but  this  did  not  induce  him  to  give  up  the  cigar 
habit,  nor  did  the  knowledge  that  this  fear  was  partially 
responsible  for  his  symptom  cause  the  burning  sensation  to 
disappear.  But  the  symptom  has  lost  very  much  of  its 
intensity  and  persistency  since  we  discovered  that  it  also 
represented  the  fear  of  cancer  by  infection  from  his  mother 
(whose  breast  had  been  amputated  a few  years  before),  the 
fear  of  oral  infection  from  indulgence  in  a perversion  for 
which  he  had  an  almost  uncontrollably  strong  desire. 
Neither  the  intensity  of  the  burning,  nor  his  emotions 
regarding  it,  gave  any  hint  as  to  the  intensity  of  the  emotions 
in  the  fears  and  desires  behind  it,  but  it  wqs  sufficient  to 
induce  him  to  cut  down  his  smoking,  to  develop  a habit 
of  chewing  gum  after  every  smoke  (“to  wash  away  the  irri- 
tation”) and  to  desist  from  his  perversion. 

The  second  of  the  “one  or  two  respects  in  which  it  [the 
Freudian  psychology]  seems  [to  our  critic]  to  contradict 
itself”  “is  connected  with  the  ‘censor’ — the  .force  that  sup- 
presses tendencies  into  the  unconscious.”  “Whence,” 
exclaims  Professor  Woodworth,  “comes  the  censor  with  this 
tremendous  power?”  And  in  the  sentence  concluding  this 
section  of  his  thesis  he  harks  back  to  this  query  in  the  fol- 
lowing words:  “Where  these  dominating  tendencies,  per- 
sonified by  the  censor,  come  from  and  how  they  manage  to 
suppress  the  all-powerful  and  all-motivating  unconscious 
tendencies,  remains  obscure.  ” The  inability  to  answer  the 
whence  and  how  of  the  censor,  we  submit,  is  no  more  an 
argument  for  rejecting  it  from  our  system  than  it  would  be 
for  the  psychologist  to  bury  his  books,  because  he  cannot 
tell  us  the  whence  and  how  of  thought,  of  memory,  of 
imagination,  of  feeling,  etc.  Does  the  astronomer  reject  the 
Copernican  theory  because  he  cannot  tell  us  the  whence  and 


S.  A.  Tannenbaum , M.  D.  413 

the  why  of  the  planets  and  the  forces  that  drive  them  in 
their  orbits?  Does  the  physicist  refuse  the  assistance  of  the 
atomic  thoery  because  he  does  not  know  the  whence  and  the 
how  of  the  atoms?  Does  the  biologist  scorn  the  Darwinian 
theory  because  he  cannot  explain  the  whence  and  how  of  the 
evolutionary  principle?  To  all  these  it  suffices  that  the 
theory  works,  that  up  to  a certain  point  it  explains  certain 
phenomena  and  conflicts  with  none,  and  this  is  also  true  of 
the  conception  of  the  ‘censor.’  Whence  the  censor  comes 
will  be  answered  when  we  know  whence  civilization  comes, 
whence  morality  comes,  whence  the  ethical  sense  comes, 
whence  the  evolutionary  urge  comes. 

Inasmuch  as  our  critic  professes  to  find  in  the  concep- 
tion of  the  censor  an  internal  inconsistency  in  the  Freudian 
psychology  we  shall  briefly  recapitulate  our  knowledge 
concerning  it.  The  censor  is  that  function  of  the  mind 
(psyche  or  soul)  which  refuses  to  permit  certain  natural 
tendencies  or  impulses  to  come  to  consciousness  and  which 
forces  certain  other  natural  impulses  more  or  less  permanent- 
ly out  of  consciousness.  The  tabooed,  forbidden,  excluded 
inpulses  (instinctive  desires)  are  those  to  which  a normal 
human  being  beyond  a certain  age  reacts  with  shame  or 
disgust  or  which  his  moral,  ethical  or  religious  senses  con- 
demn as  wicked  or  sinful.  Concerning  the  origin  of  the 
sense  of  shame  or  the  feeling  of  disgust  for  certain  things 
we  know  no  more  than  concerning  the  origin  of  the  kitten’s 
mouse-hunting  impulse  or  the  bird’s  nest-building  instinct. 
As  to  the  acquired  resistances  against  the  gratification,  or 
even  contemplation,  of  certain  unquestionably  pleasurable 
ego  and  sexual  instincts,  we  may  say  that  they  represent  the 
voice  of  the  parents,  the  teacher,  the  community,  and  God. 
Indulgence  in  the  condemned  instincts  would  bring  upon 
the  guilty  individual  the  loss  of  self-esteem,  the  displeasure 
of  the  beloved  parent,  the  condemnation  of  society,  the 
punitive  arm  of  the  law,  and  the  damnation  of  his  soul. 
These  are  forces  enough  to  bring  about  the  repression  of 
those  elements  of  the  very  powerful  natural  impulses  in- 
herited from  our  beastly  ancestors  that  would  interfere 
with  the  onward,  Godward  course  of  civilization.  The 
censor,  the  repressing  force  or  system,  is  therefore  a de- 


414  Some  Current  Misconceptions  of  Psychoanalysis 

rivative  of  the  social  instinct  in  man  as  well  as  of  his  impulse 
for  self  preservation.  It  stands  as  a system  of  inhibitions 
between  him  and  the  impulse  to  gratify  his  instinctive  de- 
sires. It  does  this  not  merely  as  regards  the  conflict  or 
gulf  between  the  individual’s  impulses  and  the  forces  of 
the  outer  world  which  he  has  to  overcome  if  he  is  to  gratify 
his  desires,  but  also  as  regards  the  antagonism  among  the 
impulses  themselves.  To  keep  these  powerful  impulses  from 
usurping  the  focus  of  attention  and  thereby  interfering  with 
incoming  perceptions  from  the  outer  world  (to  which  the 
individual  must  adapt  himself)  requires  the  operation  of  a 
strong  counter-force.  This  inhibiting  and  co-ordinating 
and  unifying  force  constitutes  the  censor.  These  natural, 
animal  impulses  can,  as  we  know,  be  subdued  or  held  in 
check,  but  they,  cannot  be  destroyed.  Scratch  a Russian, 
says  an  old  proverb,  and  you  will  find  a Tartar  underneath. 
This  is  not  true  of  Russians  only,  but  of  all  civilized  human- 
ity. The  primal  impulses  live  on,  perhaps  with  diminished 
ferocity  (affectivity),  but  with  sufficient  force  to  influence  all 
of  our  motives  and  actions.  Thinking  has  taught  man  not 
only  to  modify  his  environment  in  pursuing  the  gratification 
of  desires  but  also  to  so  mask  his  motives  that  he  can  satisfy 
his  forbidden  impulses  in  such  a manner  as  not  to  incur  the 
resentment  of  the  community  and  the  disapproval  of  his 
conscience.  That  the  censor’s  functioning  is  not  always 
successful  goes  almost  without  saying. 

Why  a psychologist  should  find  any  obscurity  and  in- 
consistency in  this  conception  of  “extraordinarily  strong 
and  pervasive”  instinctive  tendencies  repressed  by  stronger 
opposing  tendencies,  is  to  me  incomprehensible,  especially 
as  we  see  the  phenomenon  illustrated  every  minute  of  our 
lives.  In  the  body  politic,  which  is  only  a multiplication 
of  individuals  and  in  which  law,  religion,  morality  and  ethics 
perform  the  function  of  the  censor,  every  individual  has  to 
curb  his  natural  impulses,  no  matter  how  strong  they  may 
be,  for  the  common  good  of  the  community  of  which  he  is  a 
part.  For  the  benefit  of  the  group — and  therefore  of  every 
constituted — each  individual  sacrifices  the  gratification  of 
some  of  his  desires,  in  whole  or  in  part.  But  notwithstand- 
ing this,  every  individual  is  all  his.  life  intent  only  on  the 


S.  A.  Tannenbaum , M.  D. 


415 


satisfaction  of  his  own  pleasure  impulses;  and  when  this 
gratification  is  such  as,  because  of  its  nature  or  intensity,  is 
likely-  to  arouse  the  ill  will  of  the  community  the  individual 
circumvents  the  censor  by  disguising  his  wishes  and  actions. 
So  modest  woman  satisfies  her  exhibitionistic  tendency  by 
wearing  short  skirts  and  low-cut  gowns;  moral  man  gratifies 
his  sexual  curiosity  with  the  aid  of  burlesque  and  musical 
comedies;  big  business  satisfies  the  greediness  of  its  stock- 
holders by  organizing  “for  the  purpose  of  cheapening  pro- 
duction;” statesmen  hide  their  egoism  behind  a cloak  of 
patriotism;  covetous  nations  war  on  each  other  for  Christ’s 
sake  or  for  humanity,  etc.  The  devil  teaches  us  all  to  cite 
scripture  for  our  purposes.  Yet  no  one  asks  whence  all  this 
selfishness  comes  and  why  it  has  such  power. 

Continuing  his  arraignment  of  psychoanalysis,  Pro- 
fessor Woodworth  contends  that  “no  genuine  evidence” 
has  been  presented  to  show  that  “dreams  in  general  have  a 
“latent  content,”  or  are  the  fulfilment  of  deep-seated  and 
ordinarily  repressed  wishes.”  One  finds  it  very  difficult  to 
answer  such  a criticism,  especially  as  our  critic  admits  that 
“undoubtedly  some  dreams  may  be  fairly  interpreted  in  this 
way;  but  then,”  continues  he,  “there  are  so  many  dreams , 
and  most  of  them  yield  a Freudian  interpretation  only  by 
a forced  and  very  indirect  procedure.  ” It  is  difficult  to 
say  just  what  the  point  of  this  criticism  is.  Surely  no  one 
expects  a psychoanalyst  to  prove  that  all  dreams  have  a 
“latent  content”  or  that  they  are  all  the  imaginary  and 
disguised  fulfilment  of  repressed  wishes.  In  the  first  place, 
the  Freudians  do  not  assert  that  all  dreams  have  a latent 
content;  young  children’s  dreams  and  some  dreams  of  adults, 
for  example,  say  exactly  what  they  mean.  In  the  second 
place,  the  practical  proving  of  a universal  proposition  is 
impossible.  In  the  third  place,  the  method  of  science  does 
not  depend  upon  such  proof.  Science  is  content  to  formulate 
the  results  of  its  investigation  of  a large  number  of  instances 
of  a certain  phenomenon  and  then  to  test  every  additional 
instance  of  such  phenomenon  by  the  newly  acquired  formu- 
la. The  only  way,  then,  to  prove  the  formula  incorrect  is  to 
find  even  a single  instance  of  the  phenomenon  covered  by  the 
formula  in  which  the  formula  does  not  work;  until  such  a 


41 6 Some  Current  Misconceptions  of  Psychoanalysis 

failure  is  discovered  the  formula  is  entitled  to  be  considered 
a law.  So  far  no  such  failure  of  the  Freudian  law  of  dreams 
has  been  published.  That  the  technique  is  difficult  and  com- 
plicated is  no  objection  to  the  theory.  Considering  the  un- 
derlying principles  of  dream  construction,  which  our  critic 
has  not  disproved,  and  the  necessity  for  evading  the  censor, 
many  dreams  must  be  difficult  of  analysis.  The  process  of 
extracting  gold  or  radium  from  its  ore  is  very  complicated  and 
troublesome;  but  it  can  be  done  and  has  proved  worth  while. 
So  is  it  with  dream  analysis.  If  it  had  not  been  for  the 
difficulties  inherent  in  dream  analysis  the  dream  problem, 
which  must  have  engaged  the  curiosity  of  man  from  his  first 
waking,  would  have  been  solved  long  ago.  It  was  only  with 
the  solution  of  that  other  great  psychic  mystery,  the  neurosis 
problem,  that  it  became  possible  to  explain  the  function, 
characteristics  and  meaning  of  dreams.  And,  considering 
the  complicated  mechanisms  involved  in  the  synthesis  of 
most  dreams,  it  should  be  expected  that  their  analysis  would 
be  correspondingly  complicated  and  difficult. 

Next  our  critic  confronts  us  with  momentous  question: 
“Why  should  the  dream  require  such  deep  motivation?” 
I do  not  think  that  we  need  answer  this  question.  One 
might  with  as  much  reason  ask  why  the  sun  must  shine,  why 
snow  must  be  white,  or  why  the  tides  require  the  moon’s 
attraction,  or  why  the  planets  must  obey  the  force  of  gravi- 
tation, etc.  It  would  be  quite  as  fair  to  ask  ‘why  should  it 
not?’  The  why  of  things  we  shall  know,  if  ever,  on  the 
Judgment  day.  The  how  is  all  that  science  can  determine 
or  seek  to  determine.  Seeing,  however,  that  even  during 
sleep  the  psyche  continues  its  operations  and  that  unsatisfied 
desires  then  throng  to  the  fore,  isn’t  it  most  natural  that  the 
more  powerfully  affective  desires  should  prevail  over  the  less 
affective  ? 

In  truly  professorial  manner,  Dr.  Woodworth  proclaims 
that  although  “reverie  and  relatively  uncontrolled  thinking 
are  almost  always  steered  by  some  interest — it  [the  dream 
reverie]  does  not  require  anything  deep-seated  or  extremely 
powerful  in  the  way  of  a motive  force.”  Here  we  have  a 
simple  question  of  fact  which  can  be  answered  only  by 
interrogating  nature.  The  Freudians  point  to  their  analyses 


S.  A.  Tannenbaum,  M.  D. 


417 


as  proofs  of  their  claims;  but  the  anti-Freudians,  among 
whom  we  include  our  critic,  though  they  threaten  us  with 
evidence,  never  produce  anything  but  ex-cathedra  pro- 
nouncements based  on  their  preconceived  notions  and  their 
ancient  prejudices.  They  never  put  themselves  at  the 
disposal  of  the  analyst  and  never  conscientiously  apply 
Freud’s  principles  to  their  own  dreams. 

Our  analyses  show  that  reveries  are  always,  not  merely 
“almost  always,”  “steered  by  some  interest” — and  not 
merely  by  “some  interest”  (as  our  critic  cautiously  asserts) 
but  by  some  powerful  interest,  And  the  same  is  true  of  all 
“relatively  uncontrolled  thinking.”  But  this  is  very  differ- 
ent from  saying,  as  Dr.  Woodworth  does,  that  the  dream 
[or  reverie]  is  interesting  to  the  dreamer  at  the  time  and  that 
in  this  sense  “some  interest  is  gratified  by  the  dream- 
reverie.”  It  is  because  the  association  mechanisms  are  so 
easy-running — a fact  which  the  Freudian  school  does  not 
ignore,  but  the  full  significance  of  which  it  is  the  first  to 
realize  and  to  make  use  of — and  because  the  unsatisfied 
longings  of  human  beings  are  so  domineeringly  intrusive,  so 
responsive  to  the  slightest  provocation,  (“tickle  o’ the  sere” 
as  Shakespeare  would  have  put  it),  like  the  djinn  in  the 
story  of  “The  Fisherman  and  the  Brass  Bottle,”  that 
fantasies  and  dreams  are  so  easily  engendered  (as  soon  as 
conscious,  purposive  thinking  is  relaxed)  and  so  fantasti- 
cally elaborated.  Experience  shows  that  though  relatively 
superficial  interests  are  the  starting  point  of  many  fantasies 
and  dreams,  these  ally  themselves  with  deeper-liyng  interests 
of  a kindred  nature  and  of  great  intensity.  That  the 
superficial  interests  of  the  day  are  not  sufficient  to  account 
for  the  phenomena  of  dreaming  has  been  abundantly  proved 
and  need  not  detain  us  now.  “The  question  is,  whether  we 
must  assume  deeper-lying,  powerful  though  suppressed 
tendencies  in  addition  to  those  that  are  clearly  at  work.” 
But  we  respectfully  submit  that  is  not  the  question.  The 
question  is — and  it  is  a question  which  will  not  be  decided  by 
professorial  ipse  dixits — whether  the  co-operation  of  power- 
ful, repressed  tendencies  in  the  construction  of  dreams  is  a 
fact.  Our  experience  says  it  is. 


41 8 Some  Current  Misconceptions  of  Psychoanalysis 

In  discussing  lapses  (of  the  tongue,  pen,  etc.)  and  for- 
gettings,  our  critic  constructs  a man  of  straw  and  then  pro- 
ceeds to  demolish  it;  and,  having  done  so,  thinks  he  has 
disposed  of  his  adversary.  So  he  declares  it  unnecessary 
(p.  16)  “to  invoke  deep-lying  motives  to  explain  lapses  and 
complex  indicators.”  In  the  absence  of  a qualifying  word 
we  must  assume  that  he  means  all  lapses.  And  yet  he  goes 
on  to  say,  taking  back  with  the  left  hand  the  comfort  he  has 
given  the  anti-Freudians  with  the  right  hand,  “undoubtedly 
some  cases  of  hesitation  or  forgotten  names,  etc.,  may  be  due 
to  the  stirring  of  sleeping  complexes,” — a statement  to 
which  every  Freudian  would  consent  with  all  his  heart  if 
only  the  Professor  would  omit  the  use  of  the  objectionable 
adjective  “sleeping.”  After  this  admission  our  critic  goes 
on  to  show  that  numerous  instances  of  erroneous  psychic 
functioning  (“lapse”)  in  the  normal  result  from  superficial 
factors,  e.  g.,  perseveration,  anticipation,  confusion,  economy, 
etc.  “Lapses  of  the  tongue,  or  of  the  fingers  in  typewriting, 
are  in  general  [N.  B.!]  readily  explained  by  one  or  another 
of  these  simple  mechanisms.”  To  all  of  which  we  give  our 
hearty  approval  and  say:  “Let  the  galled  jade  wince;  our 
withers  are  unwrung.”  Neither  Freud  nor  any  of  his  dis- 
ciples has  ever  claimed  more  than  Dr.  Woodworth  concedes. 
All  that  the  psychoanalysts  maintain  is  that  in  addition  to 
the  cases  of  lapses  of  all  kinds  (in  speaking,  writing,  printing, 
thinking,  remembering,  etc.)  resulting  from  causes  assigned 
by  psychologists,  there  are  numerous  cases  which  result 
from  the  operation  of  affective  factors  emanating  from  the 
unconscious. 

Dr.  Woodworth  precedes  an  interesting,  though  super- 
fluous, resume  of  the  psychological  commonplaces  about 
forgetting  with  the  remark  that  after  bringing  forward  a few 
striking  though  doubtful  instances  of  forgotten  names, 
Professor  Freud  “hastily  concludes  that  all  temporary 
inability  to  recall  a fairly  familiar  name  is  the  result  of  inter- 
ference by  a submerged  complex.”  That  this  statement  is 
a wholly  false  presentation  of  Freud’s  view  will  be  evident  to 
any  one  who  considers  the  concluding  sentence  of  Freud’s 
chapter  on  “forgetting  proper  names:”  “in  addition  to  the 
simple  forgetting  of  proper  names  there  is  also  a forgetting 


S.  A.  Tannenbaum,  M.  D. 


419 


which  is  brought  about  by  repression.”  What  need  then 
for  our  critic’s  caution  that  “it  is  both  unnecessary  and 
impossible  to  extend  Freud’s  interpretation  of  the  forgotten 
name  to  cover  all  the  cases?” 

In  his  discussion  of  “suppression” — “one  of  the  most 
important  conceptions  in  the  whole  Freudian  collection” — 
our  critic  is  again  miles  away  from  an  understanding  of  the 
psychoanalytic  theory.  In  the  first  place,  he  does  not  dis- 
tinguish between  “repression” — the  nearest  English  equiv- 
alent of  the  German  word  “ Verdrangung” — and  the  super- 
ficial suppression  of  certain  banal  purposes  and  tenden- 
cies in  everyday  life  necessitated  by  the  conventions  or  by 
the  impossibility  of  more  than  one  presentation  being  in 
the  focus  of  consciousness  at  one  time.  No  Freudian  is  so 
stupid  as  to  maintain  that  every  tendency  that  is  not  per- 
mitted to  work  itself  out  in  action  is  “suppressed  into  the 
unconscious,  where  it  remains  dammed  up,  likely  to  break 
out  in  unexpected  ways.”  We  too  know  that  “most  of  the 
tendencies  thus  nipped  in- the  bud  simply  disappear.”  The 
Freudian  repression  pertains  not  to  unacted  tendencies  of 
a trivial  sort  but  to  those  unacted  impulses  whose  perfor- 
mance would  give  rise  to  fear,  shame  or  disgust  in  the  doer. 
These  repressions  are  due  to  the  individual’s  aversion  to 
experiencing  these  emotional  reactions,  to  his  desire  to  deny 
the  existence  in  him  of  tendencies  conflicting  with  his  ego- 
ideal.  This  is  a very  different  matter  from  a suppression  of 
the  impulse  to  exchange  a friendly  ‘good  morning’  with  a 
neighbor  when  one  sees  his  car  coming  or  suddenly  becomes 
aware  that  the  wind  has  blown  his  hat  away.  In  the  second 
place,  Dr.  Woodworth  admits  that  some  “suppressions” 
(to  use  his  term)  do  act  as  described  by  Freud,  and  with 
this  admission  Freudians  will  be  content. 

No  anti-Freudian  blast  is  complete  without  its  fling  at 
the  “libido,”  the  force  that  is  behind  the  symptoms  of  the 
neurotic  and  many  of  the  activities  of  the  normal.  And 
accordingly  we  find  it  here  too.  It  is  true  that  the  term  is  a 
very  vague  one  as  generally  employed  and  that  even  psycho- 
analysts are  not  agreed  as  to  its  meaning.  To  Freud  it  is 
the  sexual  impulse  or  sexual  pleasure;  to  others  it  is  a yearn- 
ing or  craving;  to  still  others  it  is  the  life  force,  the  vital 


420  Some  Current  Misconceptions  of  Psychoanalysis 

principle,  etc.  Freud,  however,  is  very  careful  tentatively 
to  distinguish  between  the  sexual  impulses  and  the  ego  im- 
pulses; so  that  Dr.  Woodworth  is  wholly  unjustified  (p.  20) 
in  imputing  to  Freud  the  doctrine  that  all  human  motives 
are  transformations  of  the  libido.  Whether  the  libido,  as 
defined  by  Freud,  is  a different  impulse  from  the  other  im- 
pulses activating  man  or  whether  they  are  all  only  varieties 
of  one  impulse  is  still  an  open  question.  From  a scientific 
standpoint  there  is  no  more  objection  to  naming  one  phase 
of  this  energy  “libido”  than  there  is  for  naming  others 
“light,”  “heat,”  “electricity,”  “magnetism.”  That  the 
psychoanalyst  finds  the  “libido”  the  essential  motive  power 
for  the  psychoneuroses  as  well  as  for  dreams  and  other 
products  of  man’s  fantasy  (myths,  religions,  etc.) — the 
special  field  of  his  investigations — is  no  more  deserving  of 
reproach  than  the  biologist’s  discovery  that  man  is  descended 
from  the  brutes.  The  psychoanalyst  does  not  deny  that 
other  motive  forces  play  important  roles  in  human  activities, 
but  these  lie  outside  of  his  special  field  of  investigation; 
that  is  why  they  figure  so  little  in  his  writings  and  why  the 
“libido”  holds  the  centre  of  the  stage.  It  is  as  absurd  to 
condemn  the  Freudian  for  doing  this  as  it  would  be  to 
condemn  the  discoverer  of  any  new  principle,  e.  g.,  natural 
selection,  for  applying  it  to  kindred  phenomena  in  other 
spheres. 

With  an  amazing  disregard  for  historical  accuracy,  Dr. 
Woodworth  says:  “ By  such  reasoning ” [as  that  which  he 
attributes  to  Freud]  “ostensibly,  the  conclusions  are  reached 
that  dreams  have  a hidden  meaning  very  different  from 
their  manifest  content,”  etc.  In  truth  and  in  fact,  this 
doctrine  was  a purely  accidental  discovery  made  by  Pro- 
fessor Freud  as  a result  of  the  patients’  analyses  of  their 
dreams.  In  response  to  Dr.  Woodworth’s  repeated  asser- 
tion that  “there  is  actually  no  evidence  that  dreams  in 
general  have  a latent  content,  or  are  the  fulfilment  of  deep- 
seated  and  ordinarily  repressed  wishes,”  although  “some 
dreams  may  be  fairly  interpreted  in  this  way,”  we  shall 
briefly  summarise  the  evidence  on  this  subject  at  our  com- 
mand. 


S.  A.  Tannenbaum,  M.  D. 


42 1 


1.  Many  of  the  dreams  of  children  are  manifestly 
wish-fulfilments.  This  is  also  true  of  many  dreams  of 
adults.  A child  that  was  sent  hungry  to  bed  was  heard  to 
murmur  in  its  sleep  the  names  of  its  favorite  dishes.  A 
male  patient  of  mine  who  lost  a very  lucrative  position 
seven  years  ago  dreamt  recently,  the  night  before  he  quit 
a very  poor  “job,*”  that  he  was  back  with  his  old  firm  and 
everybody  was  very  glad  to  see  him.  Another  patient  of 
mine  who  was  robbed  by  his  partners  of  a contract  proving 
his  co-partnership,  dreamt  that  he  found  the  contract  and 
was  reading  it  with  a great  deal  of  pleasure. 

2.  There  are  a great  many  dreams  in  which  the  wish- 
fulfillment  is  not  so  obvious  but  can  be  easily  discovered 
if  one  knows  all  the  circumstances  preceding  the  dream. 
E.  g.,  an  unhappily  married  woman  dreams  that  she  is  again 
doing  book-keeping  for  the  firm  for  which  she  worked  before 
her  marriage.  (Latent  wish  to  be  single  again  and  back 
with  the  firm  that  held  her  in  high  esteem.)  A widow  who 
is  barred  from  re-marriage  because  she  is  burdened  with  a 
child,  dreams  that  the  child  dies  of  diphtheria.  A very  tired 
school  teacher  dreams  one  morning  that  he  is  in  his  class- 
room giving  a lesson.  (Being  in  school  already  he  need  not 
awake).  Such  “anticipating  dreams”  and  “consolation 
dreams”  are  very  common. 

3.  Dreams  in  which  a person  satisfies  some  bodily 
need  or  which  imply  that  he  is  free  from  some  malady  (from 
which  he  is  really  suffering)  are  obvious  wish-fulfillments 
and  promoters  of  sleep.  Thus,  a thirsty  man  dreams  that  he 
is  at  a banquet  where  champagne  is  dispensed  in  abundance; 
a professional  acrobat,  troubled  with  a boil  on  his  neck, 
dreams  that  he  is  performing  as  usual,  etc. 

4.  Many  sexual  dreams  are  so  thinly  disguised  that 
there  can  be  no  doubt  as  to  their  meaning,  e.  g.,  the  dream  of 
the  man  running  up  the  street.  (See  above). 

5.  If  so  many  dreams  easily  permit  themselves  to  be 
interpreted  as  wish-fulfillments,  why  may  we  not  assume 
that  wishes  are  the  motive  power  of  all  dreams?  And  if 
in  so  many  dreams  the  wish,  especially  a sexual  wish,  is 
represented  in  a symbolic  way,  why  may  we  not  assume  that 
other  dreams  too  may  be  the  symbolic  utterances  of  the 


422  Some  Current  Misconcepttons  of  Psychoanalysis 

unconscious?  At  any  rate,  it  is  perfectly  permissible  to 
put  these  dreams  to  the  test,  and  if  after  such  an  examination 
these  dreams  reveal  allusions  or  references  to  significant 
matters  or  desires  in  the  dreamer’s  soul  and  permit  an  in- 
telligible or  meaningful  synthesis,  there  can  be  no  objection 
to  regarding  the  dreams  as  the  symbolic  fulfillment  of  these 
desires. 

6.  If  the  psychoanalysts’  investigations  prove,  or 
create  the  probability,  that  all  other  psychic  phenomena 
hitherto  regarded  as  obscure,  meaningless,  and  causeless, 
e.  g.,  neurotic  symptoms,  certain  lapses,  reveries,  hypnogogic 
and  hypnopompic  hallucinations,  spontaneous  (not  con- 
sciously evoked)  thoughts,  certain  forgettings,  etc.,  are 
definitely  determined,  i.  e.,  are  the  results  of  ascertainable 
unconscious  motives,  why  may  he  not  tentatively  assume 
that  dreams  too  are  so  determined  and  may  be  interpreted 
by  the  method  he  applies  to  these  other  phenomena  ? 

7.  The  free  association  method,  carefully  carried  out, 
has  proved  in  thousands  of  instances  that  almost  all  dreams 
of  adults  have  a latent  content  and  are  the  disguised  and 
imaginary  fulfillment  of  repressed  wishes. 

8.  The  fact,  which  has  been  experimentally  proved, 
that  hypnotized  subjects,  ordered  to  dream  of  certain 
matters,  do  so  in  a disguised  and  symbolic  manner,  also 
proves  that  dreams  may  have  a latent  content  which  can 
be  interpreted  if  one  has  the  key  to  the  dreamer’s  soul. 

Dr.  Woodworth  also  touches  upon  the  subjects  of  sub- 
limation and  the  psychoanalysts’  knowledge  of  children, 
but  inasmuch  as  he  dismisses  these  with  a mere  magisterial 
pronunciamento,  and  as  the  volume  of  our  comments  has 
already  exceeded  our  intentions,  we  shall  say  nothing  of  these 
matters  now.  As  to  the  Professor’s  pasquinade  in  which 
he  analyses  psychoanalysis  as  a sort  of  reductio  ad  absurdum, 
we  shall  only  say,  without  any  disrespect  or  irritation,  that 
it  is  probably  no  more  than  a bit  of  psychologic  facetiousness, 
and  that  as  criticism  of  psychoanalysis  it  is  not  of  more 
significance  than  Tolstoy’s  burlesque  of  Shakespere’s  “King 
Lear.” 


OBSESSIVE  HALLUCINATIONS  AND 
PSYCHANALYSIS 


BY  ALFRED  GORDON,  M.  D. 

Philadelphia 

IN  normal  life  as  well  as  in  pathological  states  images 
may  arise  in  the  sphere  of  the  sensorium  which  at  first 
thought  have  no  relationship  to  objective  reality.  A 
false  image  accepted  by  an  individual  in  whose  brain 
it  developed  does  not  always  mean  an  abnormal  pathological 
phenomenon.  Such  images  are  perfectly  compatible  with 
integrity  of  intellectual  faculties.  The  correctness  of  this 
contention  can  be  seen  in  the  phenomena  of  dreams  which 
are  after  all  nothing  else  but  hallucinations.  It  is  true  that 
they  are  passive  and  deprived  of  relative  emotional  elements, 
nevertheless  the  individual  is  the  witness  and  spectator  of 
the  dreaming  drama  which  is  displayed  before  him  and  which 
remains  purely  sensorial. 

In  waking  state  it  happens  that  especially  when  we  are 
in  solitude,  we  abandon  ourselves  to  phantasies  of  our 
imaginative  faculties  and  we  see  before  us  all  sorts  of  images 
of  our  past  life  in  which  we  even  may  take  part  automatically 
until  a sudden  noise  interrupts  us  in  our  contemplation. 
One  must  therefore  admit  that  hallucinating  may  be  a nor- 
mal physiological  phenomenon.  In  both  instances,  viz.  in 
dreaming  and  waking  states  during  the  hallucinating  phase 
there  is  only  an  automatic  cerebration  and  the  moment  the 
consciousness  is  awakened,  immediately  the  purely  sub- 
jective images  are  suppressed. 

The  conception  of  two  kinds  of  psychic  activities  is  now 
admitted  by  every  observer.  In  one  variety  they  are  under 
cerebral  control,  otherwise  speaking  our  faculties,  such  as 
judgment,  reasoning  and  reflexion  are  all  the  result  of  active 
and  voluntary  cerebration.  The  other  category  of  our 
psychic  activities  consists  of  an  involuntary  and  passive 
cerebration  which  is  being  displayed  when  the  former  is  sup- 
pressed. Here  ideas,  impressions,  thoughts,  wishes,  sensa- 

423 


424  Obsessive  Hallucinations  and  Psychanalysis 

tions  and  experiences  in  general  which  occurred  in  the  past, 
although  apparently  forgotten,  are  reproduced,  such  as  we 
have  seen  in  the  above  mentioned  examples  of  dreaming 
states.  As  the  latter  are  but  hallucinatory  manifestations 
we  must  infer  that  hallucinations  are  the  result  of  the  activi- 
ties of  the  subconscious  world.  Esquirol  long  ago  said  that 
sensations  in  hallucinations  are  but  ideas  reproduced  by 
memory  (Des  Maladies  Mentales  1838).  Baillarger  also 
sees  in  the  hallucinatory  phenomena  old  stored  up  energies 
which  in  some  way  gained  a spontaneous  outlet.  All  our 
past  experiences  in  the  intellectual  and  sensory  spheres 
which  almost  never  disappear  totally  and  which  could  con- 
veniently be  called  “complexes”  may,  as  especially  em- 
phasized in  Freud’s  analytic  studies,  reach  the  conscious 
ego  and  assert  themselves  as  fanciful  picture  formations,  viz. 
hallucinations. 

In  normal  conditions  we  may  speak  of  hallucinations 
only  with  respect  to  dreams  in  the  sleeping  and  -waking 
states  when  normal  consciousness  is  temporarily  suppressed. 
But  in  certain  pathological  states  the  hallucinations  exist 
alongside  of  conscious  cerebral  control.  The  individual 
realizes  their  existence  at  the  time  of  their  development,  he 
memorizes  them  and  is  able  to  present  a detailed  account  of 
them.  Here  the  hallucinatory  images  are  also  a reproduc- 
tion of  more  or  less  re„mote  events  which  have  actually  oc- 
curred in  the  lives  of  the  individuals.  While  in  some  cases 
the  reproductions  are  exact,  in  others  they  are  somewhat 
modified  from  the  original,  in  still  others  we  observe  com- 
plete substitutions  which  apparently  have  no  resemblance 
to  the  former  events,  but  a close  analysis  will  invariably 
reveal  the  past  experiences  in  toto:  their  appearance  alone 
had  changed  but  not  the  quintessence.  The  fundamental 
characteristic  of  these  hallucinations  is  not  only  a perfect 
lucidity  of  mind  but  also  and  especially  the  co-existence  of 
the  conscious  and  controlling  ego  during  the  period  of  hal- 
lucinating. The  individual  witnesses,  so  to  speak,  the  dis- 
play of  hallucinatory  phenomena  before  his  sensorium  in  the 
auditory,  visual  or  other  spheres.  He  realizes  fully  their 
unreality,  the  absence  of  a material  basis  for  those  images, 
he  does  not  attribute  to  them  any  serious  meaning,  he  is 


Alfred  Gordon , M.  D. 


4?- S 

even  capable  to  criticize  them  and  to  find  a plausible  ex- 
planation for  them.  In  a certain  group  of  cases  the  in- 
dividual bends  every  effort  to  overcome  and  discard  them 
and  indeed  sometimes  succeeds  in  his  efforts,  but  he  never- 
theless sees  and  hears  them  passing  invariably  before  him. 
In  some  cases  they  are  so  tenacious  that  the  individual 
ceases  to  struggle  against  them,  accepts  them  as  inevitable 
phenomena,  becomes  used  to  them,  but  at  no  time  does  he 
develop  the  idea  of  their  reality  or  enters  into  the  domain 
of  interpretations  such  as  we  observe  in  Delusional  states. 

When  the  hallucinations  reach  such  a state  of  tenacity 
that  they  persist  in  spite  of  the  patient’s  efforts  to  remove 
them,  they  play  the  same  role  as  obsessive  ideas.  As  is 
well  known,  when  a morbid  obsession  occurs,  the  cerebral 
centres  are  invaded  by  a certain  idea  which  remains  fixed 
and  suppresses  subsequently  all  antagonistic  ideas.  This  is 
accomplished  not  without  a struggle,  but  the  tenacious  idea 
is  accompanied  by  a moral  pain  so  intense  that  it  subordi- 
nates the  will,  and  the  individual,  perfectly  conscious  of 
what  is  going  on,  but  powerless,  finds  himself  irresistibly 
forced  towards  acts  of  which  he  himself  disapproves.  In- 
stead of  persistent  and  tenacious  ideas  the  patient  may  wit- 
ness persistent  and  tenacious  hallucinatory  phenomena. 
The  latter  may  crowd  his  sensorium  as  obstinately  as  ideas 
themselves  and  consequently  they  become  obsessive.  In 
other  cases  hallucinatory  phenomena  may  be  added  to  the 
group  of  obsessive  ideas  and  then  they  play  the  same  role 
as  any  of  the  other  elements  of  the  obsessions.  We  then 
speak  of  hallucinatory  obsessions. 

The  obsessive  hallucinations  of  the  first  group  may  re- 
main as  such  until  their  complete  disappearance,  but  in  a 
certain  group  of  cases  they  may  be  the  point  of  departure 
of  eventual  delusive  ideas.  The  modus  operandi  in  such 
cases  is  as  follows.  For  a time  these  patients  realize  the 
absurdity  of  the  condition,  because  their  reasoning  power  is 
preserved  in  spite  of  the  fact  that  they  are  conscious  of  the 
want  of  harmony  between  the  will  and  the  inability  to 
remedy  the  condition.  Gradually  the  patient  commences  to 
analyze  the  obsessive  hallucinations  and  from  this  time 
dates  his  delusional  turn  of  mind.  He  then  loses  all  power 


426  Obsessive  Hallucinations  and  Psychanalysis 


of  critical  judgment,  becomes  passive,  ceases  to  struggle 
against  the  overwhelming  obsessions.  His  consciousness 
which  helped  him  before  to  struggle,  becomes  absorbed  and 
he  accepts  the  condition,  finds  complete  justification  for  it 
and  ascribes  it  to  some  tangible  cause.  A genuine  delusion 
is  then  formed. 

Transition  of  obsessions  to  delusions  is  not  a very 
frequent  phenomenon.  This  possibility  was  first  pointed 
out  by  Schule  and  especially  by  Seglas  in  1887  (Annales 
Medico-Psychologiques).  In  1904  (Medical  News)  and  in 
1914  (American  Journal  of  Insanity)  I reported  several  ex- 
amples of  this  occurrence.  In  some  of  them  one  finds  that 
the  source  of  origin  of  the  delusive  ideas  lies  in  the  hallucin- 
atory manifestations.  In  obsessions  in  general,  whether  of 
ideational  or  hallucinatory  type,  consciousness  is  always  dis- 
turbed, but  only  in  a primitive  stage  or  in  a rudimentary 
proportion.  But  when  a complete  dissociation  of  con- 
sciousness or  a split-up  occurs,  the  latter  has  no  more  control 
over  the  psychic  processes  and  delusive  interpretations 
easily  develop. 

Turning  our  attention  to  the  consideration  of  obsessive 
hallucinations  we  find  that  they  are  but  an  exteriorization 
of  the  predominant  subconscious  thoughts  of  the  obsessed 
individual.  It  seems,  like  in  the  example  about  to  be  re- 
lated, as  if  the  past  experiences  which  actually  occurred  and 
remained  dormant  so  to  speak,  become  displaced  or  aroused 
through  some  unexpected  or  sudden  emotional  disturbance 
and  thus  give  an  impetus  to  self-reproduction.  It  is  in- 
teresting to  observe,  and  this  is,  I believe,  the  view  shared 
by  the  majority  of  writers,  that  the  awakening  or  reproduc- 
tion of  old  forgotten  impressions  in  the  identical  or  modified 
forms  as  obsessive  phenomena,  is  met  with  in  individuals 
with  a pathological  emotivity,  viz.,  affectivity.  Under  the 
latter  term  we  understand  feeling,  mood  and  emotion  of  all 
degrees.  That  thought,  impressions  and  action  are  the 
resultant  of  affectivity  is  evident  in  normal  life  as  well  as  in 
disturbed  states.  When  the  affectivity  is  of  an  abnormal 
make-up,  all  its  elements  are  proportionately  abnormal. 
Hence  the  formation  of  ideas  and  impressions  are  corre- 
spondingly not  in  keeping  with  normal  states.  Moreover, 


Alfred  Gordon , M.  D. 


427 


the  reaction  of  such  an  affectivity  by  disturbing  factors,  the 
rapidity  and  the  facility  with  which  complexes  are  awakened 
and  brought  to  the  surface,  finally  the  formation  of  obsessions 
from  the  latter — are  all  possible  and  indeed  are  all  manifest 
solely  in  specially  constituted  individuals.  They  are  ob- 
served in  adults  as  well  as  in  children,  but  more  rarely  in  the 
latter,  and  the  younger  the  child  the  less  frequent  the  occur- 
rence. The  reason  of  it  probably  lies  in  the  limited  number 
of  complexes  in  children.  The  case  recorded  below  is  a 
striking  example  of  the  occurrence  of  obsessions  in  the  form 
of  visual  hallucinations  in  a boy  of  five  who  happened  to 
witness  a year  previously  a runaway  accident  followed  by 
overturning  of  the  wagon  and  death  of  the  driver. 

The  boy  S.  F.,  aged  five,  is  pale,  underfed,  very  timid, 
subject  to  outbursts  of  violent  anger,  suffering  from  enuresis. 
His  intelligence  is  normal.  Two  brothers  had  chorea.  The 
mother  is  very  nervous  and  irritated  on  the  least  provoca- 
tion. The  father  never  could  make  a proper  living  for  his 
small  family,  lost  position  after  position  because  of  failure 
in  adjusting  himself  to  circumstances.  He  smokes  consider- 
ably, indulges  frequently  in  alcoholic  drinks.  In  his  youth 
he  was  committed  to  a Sanitarium  for  six  months  for  some 
mental  condition  the  nature  of  which  I was  unable  to  ascer- 
tain. The  patient  forgot  completely  the  incident  of  the 
runaway  horse.  For  a whole  year  it  was  never  mentioned 
either  by  him  or  by  any  one  in  the  family.  One  afternoon 
he  was  frightened  by  another  boy  who  suddenly  jumped  out 
from  behind  the  door.  For  two  days  he  appeared  somewhat 
nervous.  On  the  third  day  he  called  his  mother’s  attention 
to  his  inability  of  falling  asleep,  as  he  saw  before  him  a great 
many  horses  of  all  colors  and  of  different  sizes;  they  either 
stood  still  or  galloped.  He  also  saw  at  times  several  boys  on 
his  bed  or  else  little  girls  running.  The  presence  of  boys 
and  girls  was  only  occasional,  but  the  horses  were  always 
present.  These  hallucinatory  images  appeared  as  soon  as 
he  would  lie  down.  They  would  also  occur  even  during  the 
day  but  only  when  he  would  lie  down  to  rest.  The  night 
apparition  of  the  horses  was  the  most  constant  and  persist- 
ent. Although  he  was  not  afraid  of  the  visual  manifesta- 
tions, nevertheless  he  was  greatly  disturbed  by  them,  he 


428  Obsessive  Hallucinations  and  Psychanalysis 

could  not  fall  asleep  for  2 or  3 hours.  He  constantly  called 
out  to  his  mother  and  she  was  compelled  to  sit  at  his  bed. 
When  questioned  about  them,  the  child  acknowledged  their 
unreality  in  his  own  language,  saying  “so  many  horses  could 
not  find  place  in  his  room,”  nevertheless  he  sees  them  every 
time  he  lies  down  and  even  when  a light  burns  and  he  is  able 
to  appreciate  the  objects  about  him.  He  was  admonished 
by  his  parents  to  ignore  them  and  to  avoid  looking  at  the 
horses,  but  the  more,  he  said,  he  tried  to  do,  the  more  horses 
he  would  see.  He  gave  a most  vivid  description  of  the 
appearance,  color,  and  vivacity  of  some  of  the  horses.  Two 
of  them  particularly  were  very  disturbing,  as  they  always 
tried  to  escape.  He  described  their  manner  of  standing 
and  their  assortment  was  always  the  same.  They  always 
occupied  the  same  position  in  the  room. 

Being  greatly  disturbed  the  child  did  not  sleep  well, 
ate  little  and  lost  in  weight.  Psychoanalysis  was  under- 
taken. In  view  of  the  child’s  age  it  was  extremely  difficult 
to  unearth  facts  and  events  that  could  bear  any  relationship 
to  the  disturbing  visual  phenomena.  After  prolonged  efforts 
the  above  mentioned  incident  was  finally  revealed  through 
the  mother.  So  thoroughly  forgotten  it  was  by  the  mother 
and  child  that  not  once  during  the  entire  year  was  it  recalled 
by  any  of  them.  The  child’s  attention  was  then  repeatedly 
called  to  that  occurrence  and  it  was  explained  to  him  the 
possible  relationship  between  his  present  hallucinations  and 
that  particular  incident.  As  horses  figured  in  both  cases, 
he  was  told  in  his  childish  way  that  the  picture  of  the  runa- 
way horse  of  a year  ago  came  to  him  now  and  impressed 
itself  firmly  on  his  mind.  It  is  self-understood  that  any 
detailed  explanation  of  the  role  of  forgotten  complexes  on 
his  conscious  ego  was  not  undertaken.  The  therapeutic 
effort  was  only  tentative  as  little  hope  was  expected  in  view 
of  the  age  of  the  child.  Nevertheless  it  was  decided  to  per- 
sist in  the  above  explanation  at  each  of  his  visits  during  a 
period  of  two  months.  Having  become  accustomed  to  this 
sort  of  explanation,  the  little  patient  undertook  himself  to 
offer  it  to  his  mother  every  evening  as  soon  as  the  horse- 
picture  would  appear.  He  gradually  commenced  to  point 
out  the  striking  resemblance  of  the  runaway  horse  to  many, 


Alfred  Gordon , M.  D. 


429 

if  not  all  the  horses  that  he  sees  in  his  room.  The  explana- 
tions became  so  satisfactory  to  him  that  he  asked  his  mother 
not  to  sit  any  more  at  his  bed  as  he  wished  “to  fight  them 
off  single-handed.”  After  some  attempts  on  his  part  he 
finally  succeeded  in  overcoming  the  obsession.  He  solemn- 
ly announced  to  me  his  victory  and  as  he  expressed  himself, 
“since  he  knows  now  that  the  horses  are  the  same  thing  as 
the  runaway  horse,  he  does  not  care  for  them;”  also  “should 
they  return  he  is  sure  he  will  not  bother  about  them  and 
will  not  ask  for  his  mother’s  help  any  more,  as  he  can  get 
rid  of  them  himself.  ” 

The  case  is  interesting  from  the  standpoint  of  the 
intimate  mechanism  concerning  the  formation  of  an  ob- 
session in  the  form  of  a visual  hallucination.  It  appears 
that  the  pathogenesis  of  the  obsession  could  be  traced  al- 
most with  a mathematical  precision  to  the  subconscious 
complexes.  This  purely  psychological  conception  of  the 
hallucinations  seems  to  give  the  only  solution  of  the  problem. 
It  may  be  of  some  interest  to  mention  some  other  views 
concerning  the  phenomenon. 

As  it  is  well  known  some  authors  believe  that  hallucina- 
tory perceptions  are  due  to  a peripheral  irritation  of  the 
sensory  organs,  and  accordingly  they  introduced  a so-called 
psycho-sensory  doctrine  of  hallucinations.  Baillarger  and 
Tamburini  (Revue  Scientifique  1887)  consider  a hallucina- 
tion as  due  to  an  irritation  of  the  psycho-sensory  centers  in 
the  cortex.  The  last  author  believes  that  the  phenomenon 
consists  of  a spontaneous  setting  free  of  energies  stored  up 
in  the  psycho-sensory  centers.  Tanzi  (Riv.  di  Pathol. 
Nerv.  e Ment.  vol.  6)  accepting  the  psycho-sensory  doctrine 
attempts  to  be  more  concise  in  his  conceptions  by  believing 
that  hallucinations  originate  in  the  association  centers  of 
Flechsig.  To  him  the  image  starts  in  those  centres,  ascends 
to  the  psychic  area  and  descends  to  the  same  sensory  centres; 
thus  a new  form  of  sensation  occurs  which  is  mistaken  for 
reality;  hence  a hallucination.  Tanzi  bases  his  claim  for  a 
descending  centrifugal  course  of  a sensation  which  is  con- 
trary to  the  classical  conception  of  the  function  of  sensory 
pathways  upon  the  actual  existence  of  descending  fibres  in 
the  sensory  centers.  According  to  this  psychosensory 


430  Obsessive  Hallucinations  and  Psychanalysis 

theory  the  hallucination  apparently  originates  along  the 
sensory  pathway  which  as  well  may  be  at  the  periphery. 
If  now  we  attempt  to  apply  the  psycho-sensory  doctrine  to 
the  explanation  of  hallucinatory  phenomena  we  meet  with 
failure.  A careful  reading  of  records  on  hallucinosis  will 
demonstrate  the  utter  inability  to  find  a pathogenetic  ex- 
planation of  the  great  variety  of  hallucinatory  manifesta- 
tion by  the  sensory  or  psycho-sensory  view  just  mentioned. 
Exception  should  be  made  however  in  the  cases  with  an 
organic  involvement  of  the  cerebral  tissue.  In  all  other 
cases  like  the  one  presented  above,  hallucinations  are  to  be 
considered  as  purely  psychic  phenomena  based  upon  the 
existence  of  “complexes”  of  the  subconscious  ego. 


REVIEWS 


a mechanistic  view  of  war  and  peace.  By  George  W.  Crile. 
The  Macmillan  Company.  1915.  $1.25.  Pp.  104. 

“War  and  peace  can  be  comprehended  only  when  they  are 
considered  as  end  effects  of  action  patterns  established  by  phylo- 
geny  and  ontogeny,” — in  these  words  the  author  announces  his 
central  theme.  The  struggle  for  food  is  basic  in  each  individual, 
genuinely  derived  and  perpetuated  through  evolution,  and  is 
well-nigh  an  ineradicable  prime  motive,  whose  elimination  might 
even  be  of  doubtful  value.  It  is  even  more  basic  than  the  desire 
to  live  or  the  fear  of  death,  as  is  evidenced  by  the  fact  that  blood 
is  freely  shed  in  such  unimportant  matters  as  sports  or  boundary- 
line feuds.  If  stifled  by  the  thin  veil  of  polite  conventions,  or  by 
the  forced  inactivity  of  the  non-combatants  in  war,  this  action 
pattern  of  fight  generates  emotions  of  a dangerously  abnormal 
character.  War  is  also  kept  in  the  web  of  all  our  lives  by  the 
present  educational  tendency  to  exploit  chiefly  heroes  of  blood. 
Nevertheless,  two  suggestions  are  made  whereby  it  can  be  elimi- 
nated. The  first  is  that  by  establishing  action  patterns  of  peace 
inthe  plastic  period  of  youth,  the  phylogenetic  inheritance  of  the 
organism  may  be  in  time  reversed,  though  how  at  the  same  time 
the  ubiquitous  stimulations  to  strife  may  be  precipitated  out 
from  the  environment  Dr.  Crile  does  not  suggest.  The  other  road 
to  peace  rests  on  the  familiar  appeal  to  the  principle  of  the  alterna- 
tion of  opposites.  A victorious  Germany  “would  lack  the  funda- 
mental motive  which  created  Ivultur, — her  hostile  neighbors,” 
and  would  be  as  motiveless  as  “a  cancer  that  has  killed  the  body 
on  which  it  fed.”  Furthermore,  since  “Force  creates  action  pat- 
terns in  opposition  to,  not  in  consonance  with,  that  force,”  the 
Belgiumization  of  a people  is  a hopeless  task.  War  itself  is  thus 
no  solution  to  the  problems  involved. 

Of  special  importance  to  psychologists  is  the  author’s  study 
of  the  phenomenon  of  pain.  At  least  every  behaviorist  will  be 
interested  to  read  that  “pain  is  inevitably  associated  with  muscular 
action;  therefore  if  a bullet  or  bayonet  wound  is  inflicted  at  the 
moment  when  the  injury  cannot  obtain  possession  of  the  final 
common  path,  it  can  excite  no  muscular  action,  and  consequently 
no  pain.”  It  was  especially  observed  that  when  men  were  ex- 
clusively dominated  by  the  action  patterns  of  fight,  or  were  so 
completely  exhausted  that  they  slept  even  while  on  the  march,  or 
lay  down  and  bled  to  death  from  their  wounds,  no  adaptive  re- 
sponse to  pain  could  take  place,  since  no  energies  were  left  to 
function  it.  The  importance  of  this  observation  on  the  essentially 
motor  aspect  of  the  pain  reflex  is  accentuated  by  the  fact  that 
Dr.  Crile  came  to  these  conclusions  while  he  was  a surgeon  in  a 
war  hospital  in  France.  It  is  thus  not  merely  psychology  “from 
the  desk.” 


431 


432 


Reviews 


The  book  is  profusely  illustrated,  not  only  with  histological 
material  bearing  directly  on  the  phenomena  of  exhaustion  and 
emotion  exhibited  by  the  author’s  patients,  but  also  with  photo- 
graphs which  deal  with  war  in  general.  Dr.  Crile  evidently  means 
the  latter  illustrations  to  function  unequivocally  in  the  education 
toward  peace,  for  they  surely  could  not  be  used  to  stimulate  re- 
cruiting. 

Robert  Chenault  Givler. 

Harvard  University. 

THE  CIRCULATION  AND  SLEEP:  EXPERIMENTAL  INVESTIGATIONS 

accompanied  by  an  atlas.  By  John  F.  Shepard,  University  of 
Michigan , New  York.  The  Macmillan  Company,  1914.  28x21 

c m.;  pp  ix,  83;  in  the  Atlas  of  soot-curves,  63  plates. 

This  is  volume  one  of  the  Scientific  Series  of  the  University  of 
Michigan  Studies  in  the  Graduate  Department.  Professor 
Shepard  begins  his  Preface  by  stating  “This  volume  is  primarily 
a report  of  experimental  investigations.  Altogether  it  was  neces- 
sary to  study  several  hundred  records,  the  total  length  of  which 
amounted  to  about  thirty-five  hundred  feet.  Each  record  con- 
tained from  two  to  six  tracings  besides  indicator  lines.  Those 
reproduced  were,  of  course,  selected  to  show  typical  conditions.” 
Two  subjects  were  used  in  the  principal  work,  both  of  whom  had 
been  trephined,  one  in  the  right  Rolandic  region  and  the  other  in 
the  right  frontal  area.  Other  subjects  were  used  in  several  minor 
experiments. 

The  investigation11  includes  a study  of  the  volume  of  the  brain 
and  of  the  periphery  (hand  or  foot);  of  the  breathing;  of  the  blood- 
pressure;  of  the  heart-rate  and  the  time  of  transmission  of  the 
pulse  wave  over  the  body;  of  the  jugular  pulse;  and  of  the  pulse 
form  and  size.”  The  apparatus  does  not  need  detailed  description; 
it  was  undoubtedly  ingenious,  and  adequate. 

Provided  the  cerebral  vasomotion  of  the  two  chief  subjects 
proves  to  be  normal,  undisturbed  and  in  no  wise  disarranged  by 
their  respective  cranial  and  cerebral  accidents  and  operations,  it 
is  not  easy  to  see  why  this  new  notion  of  the  brain’s  sleep-circula- 
tion should  not  be  accepted,  although,  in  certain  not-very-impor- 
tant  respects,  revolutionary  of  traditional  interpretations.  One 
thinks  it  incumbent  on  the  researcher  in  this  case,  as  a matter 
of  general  form  at  least,  to  prove  the  normality  of  the  extremely 
intricate  hydraulic  vasomotor  system  of  these  two  men’s  brains. 
Some  years  of  intensive  study  of  the  arterial  tension  in  the  arm  and 
the  foot,  in  close  relation  to  physical  behavior  and  especially  to 
mental  processes,  makes  the  present  reviewer  offer  great  gratitude 
for  this  research,  and  renders  it  easy  for  him  to  accept,  with  the 
proviso  above,  practically  all  of  its  conclusions,  for  it  corroborates, 
and  mayhap  explains  some  of  the  many  difficulties  and  incon- 


Reviews 


433 


sistencies  in  the  palpatory  and  the  auscultatory  present  methods  of 
measuring  human  blood-pressures,  as  nothing  else  so  far  has  done. 

Professor  Shepard  finds  in  sleep  a sustained  and  marked 
increased  in  the  volume  of  the  brain,  accompanying  a fall  of  general 
arterial  pressure;  and  the  reverse  changes  with  awakening.  These 
changes  seem  not  to  be  due  to  venous  congestion.  Disturbances 
during  sleep  result  in  a rise  of  pressure  with  a fall  of  brain-volume 
and  decreased  size  of  pulse  from  the  brain;  due  probably  to  vaso- 
constriction; action  during  waking-time  on  the  other  hand  increases 
the  brain’s  volume,  an  effect  due  to  general  somatic  [especially 
peripheral!,  vasoconstriction.  The  brain-vessels  relax  when  the 
person  is  going  to  sleep;  and  constrict,  often  suddenly,  when  he 
awakens.  The  brain-volume  is  increased  by  breath-holding,  and 
decreased  by  deep  breathing.  The  respiratory  wave  in  the  brain’s 
volume  is  greater  during  sleep  and  greater  still  in  the  “disturbed 
respiration”  of  snoring.  Such  are  some  of  the  more  important 
findings. 

The  observer’s  “theory”  of  sleep  is  the  rational,  not  to  say 
obvious,  theory  that  includes  each  and  all  of  the  many  actual 
factors,  rather  than  pretending  to  be  simple  and  dogmatic  where 
simplicity  is  unimaginable  and  dogmatism  almost  asinine. 

And  one  admires  the  naivete  which  concludes  that  the  brain 
has  vasomotion,  when  for  fifteen  or  ten  years  at  least  the  cerebral 
vasomotion’s  intricate  structure  and  precise  modus  operandi  have 
been  interesting  matter  for  discussion,  (see,  for  example,  the 
present  reviewer’s  “ Physiology , ” pages  62  and  63.) 

The  more  observations  on  arterial  tension  there  are  made, 
the  more  obvious  does  it  become  that  therethrough  sooner  or 
later  is  possible  by  far  the  most  delicate  method  of  analysis  of 
mental  happenings  so  far  devised  or  revealed.  To  the  fundamental 
data  for  such  a new  mode  of  study,  Doctor  Shepard’s  extensive 
research  whose  outline  is,  mostly  here,  reported,  seems  an  im- 
portant contribution.  By  such  physiologic  (vasomotor)  paths  as 
this,  (but  some  sinuous  and  narrow  and  dim,  while  some  like  sin 
run  broad  and  straight-away),  and  perhaps  before  we  realize  it,  we 
shall  begin  really  to  know  ourselves , as  the  revered  old  seer  and 
martyr  to  the  truth,  in  Athens  so  long  ago,  advised. 

Sargent  Normal  School.  George  V.  N.  Dearborn. 

THE  CONTROL  OF  HUNGER  IN  HEALTH  AND  DISEASE.  Anton 

Julius  Carlson.  Chicago:  University  of  Chicago  Press,  1916,  pp. 
319- 

This  book  together  with  that  of  Cannon  marks  the  most 
important  epoch  in  the  study  of  the  hunger  mechanism.  The 
gastric  hunger  contractions  of  man  and  animals  have  been  studied 
in  the  Hull  Laboratory  of  the  University  of  Chicago  by  the  author 
and  his  associates  during  a period  of  four  years  and  the  results  of 
their  investigations  form  the  greater  part  of  the  book.  The 


434 


Reviews 


action  of  the  stomach  under  almost  every  possible  stimulation  both 
physical  and  so  called  psychic  has  been  examined.  Carlson  was 
fortunate  in  having  a subject  with  a gastric  fistula,  which  per- 
mitted direct  observation  and  stimulation  of  the  hunger  con- 
tractions. He  and  his  associates  also  acted  as  subjects  in  numerous 
experiments,  in  which  a stomach  balloon  was  used  to  obtain  tracings 
of  the  gastric  movements. 

The  book  is  probably  the  most  complete  study  of  this  subject 
and  a description  of  the  numerous  details  would  be  out  of  place  in 
this  review.  Not  only  have  the  hunger  movements  been  most 
thoroughly  investigated,  but  also  the  accessory  phenomena  such  as 
heart  beat  and  vasomotor  changes. 

Particularly  interesting  to  psychologists  are  the  actions  of  the 
various  glands  which  are  involved  in  hunger  and  appetite,  the 
effect  of  various  mental  states,  the  influence  of  sight  and  taste  of 
food,  the  description  of  the  nervous  tracts  and  the  functioning  of 
the  nervous  arcs  connected  with  hunger  and  appetite,  the  various 
muscular  rhythms,  the  effect  of  heat,  cold,  mechanical  and  chemical 
stimulations,  the  action  of  the  gastric  mechanism  during  pro- 
longed fasting  and  during  and  after  bodily  exercise  and  fatigue, 
the  analysis  of  the  hunger  sensations  and  the  feeling  of  emptiness, 
the  relation  of  the  introspective  data  to  the  physiological  processes, 
the  biological  significance  of  the  mechanism  especially  in  relation 
to  the  instincts,  and  the  important  distinction  between  hunger  and 
appetite. 

The  specialist  in  abnormal  psychology  will  find  sections  upon 
the  effect  of  alcohol  and  tobacco,  an  explanation  of  abnormally 
intense  hunger  sensations  (bulimia)  and  depraved  appetite  (paro- 
rexia) etc.,  and  upon  the  various  gastric  conditions  in  neuresthenia 
and  allied  diseases. 

The  book  contains  valuable  historical  chapters  and  a very 
good  bibliography. 

The  author  is  conservative  in  his  conclusions  and  modest  in 
his  positive  statements.  The  arguments  for  and  against  his 
theories  are  carefully  weighed  and  great  care  is  taken  to  avoid 
errors  of  experimentation,  much  time  having  been  given  to  check 
and  control  experiments.  The  author’s  style  is  clear  and  as  techni- 
cal terms  are  so  far  as  possible  avoided,  the  book  can  be  recom- 
mended to  the  layman  as  well  as  to  the  specialis. 

Herbert  Sidney  Laxgfeld. 


WAR  BULLETIN:  AN  APPEAL  TO  THE  MEDICAL 
PROFESSION 


Lieutenant  Col.  R.  E.  Noble,  M.  C.,  U.  S.  A.,  chief  of  the 
Personnel  Desk  of  the  Surgeon  General’s  Office,  presented  before 
the  last  meeting  of  the  Southern  Medical  Association,  a most 
admirable  paper,  which  convincingly  answers  the  many  questions 
asked  of  the  Department,  and  which  have  caused  perplexing  hours 
of  thought  with  many  doctors. 

In  a previous  paper  by  the  same  writer,  presented  prior  to  the 
time  that  the  United  States  entered  the  world  struggle,  as  in  the 
above  referred  to  communication,  Col.  Noble  said:  “On  the  medi- 
cal profession  rests  a heavy  responsibility,  for  with  the  medical 
profession  rests  the  subject  of  medical  preparedness.” 

The  largely  increased  army  now  in  course  of  mobilization 
naturally  will  require  a greater  number  of  Officers  in  the  Medical 
Reserve  Corps. 

At  the  present  time,  according  to  a statement  made  by  Lieut. 
Col.  Noble,  we  have  only  14,500  doctors  in  the  Medical  Reserve 
Corps,  not  a sufficient  number  to  care  for  those  already  in  the  ser- 
vice, not  mentioning  the  men  to  come  into  combatant  forces  as 
the  result  of  a second  draft. 

With  the  new  draft  soon  to  be  called  and  the  possibility  of  the 
raising  of  an  army  of  between  five  and  ten  million,  as  has  been 
authoritatively  foreshadowed,  we  would  repeat  “On  the  medical 
profession  rests  a heavy  responsibility,  for  with  the  medical  pro- 
fession rests  the  subject  of  medical  preparedness.” 

The  responsibility  of  the  medical  profession  of  the  United 
States  and  its  importance  in  the  successful  outcome  of  the  war 
cannot  be  too  forcibly  impressed  upon  every  doctor  who  is  men- 
tally and  physically  fit  and  within  the  age  limit,  and  they  are 
urged  to  offer  their  services  now. 

That  the  Surgeon  General  should  have  an  immense  Corps  of 
Medical  Reserve  Officers  upon  which  to  draw,  enabling  him  to 
place  the  individual  where  he  will  be  best  fitted  for  the  service,  is 
manifestly  apparent.  This  will  mean  efficiency  and  by  efficiency 
alone  can  the  responsibility  now  resting  upon  the  medical  pro- 
fession of  this  county  be  lessened. 

Will  you  not  apply  at  once  for  a commission  in  the  Medical 
Reserve  Corps  and  thus  relieve  the  responsibility  which  you  owe 
to  your  country,  your  profession  and  yourself? 


435 


BOOKS  RECEIVED 


the  principles  of  mental  hygiene.  By  William  A.  White. 
The  Macmillan  Company.  Pp.  XIV  and  323.  $ 2.00  net. 

STATE  OF  NEW  YORK  STATE  BOARD  OF  CHARITIES,  EUGENICS  AND 
SOCIAL  WELFARE  BULLETINS: 

No.  VIII  PERFORMANCE  NORMS  FOR  THIRTEEN  TESTS. 


Pp.  I42. 

No.  IX  NINETEEN  EPILEPTIC  FAMILIES,  A STUDY.  Pp.  94  and 

Charts. 

No.  X FIELD  WORK  MANUAL.  Pp.  1 87. 

No.  XI  MENTAL  EXAMINATIONS.  Pp.  73. 

No.  XII  FAMILY  HISTORIES.  Pp.  55. 

the  psychology  of  behaviour.  By  Elizabeth  Severn.  Dodd, 
Mead  & Co.  Pp.  IX  and  349.  $1.50  net. 

problems  of  mysticism  and  its  symbolism.  By  Dr.  Herbert 
Silberer.  Translated  by  S.  E.  Jelliffe.  Moffat,  Yard  & Co. 
Pp.  V and  443.  $3.00  net. 

diseases  of  the  nervous  system.  By  Smith  Ely  Jelliffe 
and  William  A.  White.  2nd  Edition.  Lea  and  Flebiger.  Pp. 
XIX  and  938.  $ 7.00 

the  exceptional  child.  By  Maximillian  P.  Grozeman. 
Charles  Scribners  Sons.  Pp.  XXIX  and  764.  $2.50  net. 

handicaps  of  childhood.  By  H.  Addington  Bruce.  Dodd, 
Mead  & Co.  VIII  and  310.  $1.50. 


436 


Cat 


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